Workplace Ergonomics Checklist
Please complete this checklist to help assess your workplace ergonomics.
Employee Name
First Name
Last Name
Department
Date
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Is your chair adjustable and supportive?
Yes
No
Not Sure
Is your computer monitor at eye level?
Yes
No
Not Sure
Do you have enough legroom under your desk?
Yes
No
Not Sure
Are your keyboard and mouse positioned comfortably?
Yes
No
Not Sure
Is your workstation free from glare and reflections?
Yes
No
Not Sure
Do you take regular breaks to stretch and move?
Yes
No
Sometimes
Submit
Should be Empty: