DSE Workstation Checklist

DSE Workstation Checklist
TES022v3.2
Your E-mail*
Department*
Date*

DayMonthYear

Lighting*

Rows	About Right	Too Bright	Too Dark
Describe the lighting at your usual workstation

Rows	Never	Sometimes	Constantly
Do you get distracting reflections on your screen?

TEMPERATURE AND HUMIDITY*

Rows	Comfortable	Too Warm	Too cold
At your workstation is it generally:

Rows	Comfortable	Too Dry	Too Humid
Is the air around your workstation:

Noise*

Rows	Never	Occasionally	Constantly
Do you suffer noise from work equipment such as machinery?

Space*

Rows	Adequate	Inadequate
Describe the amount of space around your workstation.

Chair*

Rows	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*

Rows	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*

Rows	Yes	No
Is a footrest required if your feet cannot touch the floor when keying?

Document Holder*

Rows	Yes	No	Already Have One
Do you require a document holder?

Display Screen*

Rows	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*

Rows	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*

Rows	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*
Should be Empty: