Fill and Sign the Checklist Workers Form

Checklist-- Ergonomics Issues for Office Workers This checklist is written in a format that would require an employee to respond yes or no.  It is easy for me to get in and out of my workstation.  My chair adjusts so that my upper legs and lower legs form a right angle.  My chair has armrests.  The keyboard sits at my waist and my upper arms and lower arms form a right angle.  My wrists are not bent while typing,  A wrist rest is available I request one.  I can tilt the keyboard to the level I need.  I can easily reach the mouse pad.  My chair back supports my lower and upper back and my feet rest comfortably on the floor.  A footrest is available if I request one.  An adjustable document holder is available if I request one.  My monitor is adjustable for contrast and brightness.  My monitor sits at or just below eye level and is not too close or too far from me,  My monitor has a glare protection screen.  There is plenty of light at my workstation; a desk lamp is available to me if I request one.  My work station easily accommodates the books and tools I regularly use.  The telephone is near my chair within easy reach.  A telephone headset is available to me if I request one.  My workload is reasonable and I do not do the same task repetitively.  I take advantage of breaks and my lunch period to get up and move around.  I have received adequate training about cumulative trauma.  I know the signs of repetitive stress injuries.  If my workstation became uncomfortable, I would feel free tell my supervisor.