DSE Workstation Checklist
TES022v3.2
Your E-mail
*
Department
*
Please Select
Operations
Sales
Business Support
Directors
Date
*
-
Day
-
Month
Year
Date Picker Icon
Lighting
*
About Right
Too Bright
Too Dark
Describe the lighting at your usual workstation
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Never
Sometimes
Constantly
Do you get distracting reflections on your screen?
TEMPERATURE AND HUMIDITY
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Comfortable
Too Warm
Too cold
At your workstation is it generally:
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Comfortable
Too Dry
Too Humid
Is the air around your workstation:
Noise
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Never
Occasionally
Constantly
Do you suffer noise from work equipment such as machinery?
Space
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Adequate
Inadequate
Describe the amount of space around your workstation.
Chair
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Yes
No
Can you adjust the height of your seat?
Is the chair stable?
Does it allow movement?
Is the chair in a good state of repair?
Does your chair have arms?
Desk
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Yes
No
Is the desk surface large enough to allow you to place all your equipment where you want it?
Is the height of the desk suitable?
Do you suffer from reflections from the surface of the desk?
Footrest
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Yes
No
Is a footrest required if your feet cannot touch the floor when keying?
Document Holder
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Yes
No
Already Have One
Do you require a document holder?
Display Screen
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Yes
No
Do the brightness and contrast controls function correctly?
Does the screen tilt or swivel freely if not lap top?
Is the screen image stable and free from flicker?
Is the screen at a height which is comfortable for you?
Keyboard
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Yes
No
Is the keyboard separate from the screen?
If separate, can you raise and lower the keyboard height?
Can you easily see the symbols on keys?
Is there enough space to rest your hands in front of the keyboard?
Training
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Yes
No
Do you require training/documentation in the safe use of your workstation?
Do you require training in the use of the software?
If you were to have a problem relating to display screen work, would you know the correct procedures to follow?
Additional Comments
Your Signature
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