Work From Home Assessment
Help us ensure your home workspace is safe, comfortable, and productive by completing this assessment.
Full Name
*
First Name
Last Name
Department
*
Job Title
*
Please rate the following aspects of your home workspace:
*
Rows
Excellent
Good
Average
Poor
Desk/chair comfort
1
2
3
4
Lighting
5
6
7
8
Noise level
9
10
11
12
Temperature control
13
14
15
16
Privacy
17
18
19
20
Do you have a dedicated workspace at home?
*
Yes
No
Which of the following equipment do you use for work at home? (Select all that apply)
*
Desktop computer
Laptop
External monitor
Ergonomic chair
Keyboard/mouse
Headset
Other
How reliable is your internet connection for work purposes?
*
Very reliable
Mostly reliable
Unstable at times
Frequently unreliable
Are you able to maintain regular communication with your team while working from home?
*
Always
Often
Sometimes
Rarely
Have you experienced any of the following while working from home? (Select all that apply)
*
Distractions (family, pets, noise, etc.)
Physical discomfort (back pain, eye strain, etc.)
Difficulty accessing files/systems
Feelings of isolation
None of the above
Other
Please rate your overall satisfaction with working from home.
*
1
2
3
4
5
Do you have any suggestions or additional comments to help us improve the work from home experience?
Submit Assessment
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