ErgoSystems Office Ergonomics Assessment
Last name:	Stature:	ft in	Work hours:
First name:	Shoe heel ht:	in	Comments:
Date:	Click here to enter a date.	Handedness:
Vision:
Company:	Job tasks:
Location:	Job demands:
User:
Other station:
Assessment performed by Mark Anderson, MA, PT, CPE, ErgoSystems Consulting Group, Inc. 19285 Shady Hills Road, Excelsior, MN 55331 Voice: 952-401-9296 Email: mark.anderson@ergosystemsconsulting.com. The purpose of the assessment is to focus on ergonomics issues of the workstation, work practices, and work process to provide a set of workstation set-up specifications and to offer reasonable suggestions to help improve comfort, safety, and productivity in the workplace. The 30/30 rule was encouraged - this promotes physical movement up and out of chair for at least 30 seconds at least every 30 minutes.
Chair	Comment	Recommendation
Type	Instructed in upright “keyboard position” and semi-reclined “conversation position”. Recommended to alternate between these two seated postures based on job tasks throughout day.
Legs
Casters
Seat
Back
Arms
Foot support/Clearance	Comment	Recommendation
Feet Footrest
Worksurface	Comment	Recommendation
Config
Type
Keyboard Tray	Comment	Recommendation
Used
Adjust
Keyboard	Comment	Recommendation
Type
Location
Mouse	Comment	Recommendation
Type
Location
CPU	Comment	Recommendation
Type
Location
Monitor	Comment	Recommendation
Type
Number
Telephone	Comment	Recommendation
Type
Location
Document holder	Comment	Recommendation
Type
Location
Storage	Comment	Recommendation
Desktop File
Lighting	Comment	Recommendation
Ambient Task

Recommended Specifications (inches)
Seatpan height:	Seatpan height is distance from floor to seatpan (at side of seatpan) with user in chair.
Seatpan depth:	Seatpan depth is distance from back support to front of seatpan and allows for 1.5 to 2” of space between back of the knee and front of seatpan.
Seatpan width:	Seatpan width is distance side-to-side of seatpan; allows for 1.5 to 2” between thigh and side of seatpan.
Armrest height:	Armrest height is distance from top of armrest to floor.
Armrest width	Armrest width is distance between armrests measured from outside edge of each armrest.
Writing / reading desk:	Worksurface height (writing/reading desk) is distance from floor to top surface of worksurface.
Keyboard / mouse height:	Keyboard/mouse height is distance from floor to top surface of platform that keyboard/mouse rest on.
Monitor height:	Monitor height is height from floor to top of monitor screen (not the top of monitor bezel.)
Monitor distance:	Monitor distance is from eye position (bridge of the nose between the eyes) to screen.