Office Ergonomics Job Hazard Assessment

General Information

Employee Name Job Title Department Assessment Date Assessor

Workstation Setup Assessment

Item	Status (Yes/No)	Comments
Chair height adjustable
Monitor directly in front of user
Monitor at eye level
Keyboard/mouse at comfortable position
Feet flat on floor or on footrest

Task Analysis

Typical Tasks Performed Description of Work Patterns

Hazards Identified

Hazard	Observed?	Comments
Poor posture
Inadequate lighting
Prolonged sitting
Repetitive motions

Recommended Actions

Follow-Up / Comments