SELF ASSESSMENT CHECKLIST
==========================




Name: ___________________________________________________________

Department: _____________________________________________________

Date: ____________________



The completion of this checklist will enable you to carry out a self assessment

of your own workstation. Your views are essential in order to enable us to

achieve our objective of ensuring your comfort and safety at work. Please circle

the answer that best describes your opinion, for each of the questions listed.



The form should be returned to......................................as soon as

it has been completed.



ENVIRONMENT
------------

1. Lighting

Describe the lighting at your usual workstation.

           about right        too bright        too dark

Do you get distracting reflections on your screen?

           never              somtimes          constantly

What control do you have over local lighting?

           full control       some control      no control



2. Temperature and humidity

At your workstation, is it usually:

           comfortable        too warm          too cold

Is the air around your workstation:

           comfortable        too dry



3. Noise

Are you distracted by noise from work equipment?

           never              occasionally      constantly



4. Space

Describe the amount of space around your workstation.

           adequate           inadequate





FURNITURE
----------

5. Chair

Can you adjust the height of the seat?

           yes                no

Can you adjust the height and angle of the backrest?

           yes                no

Is the chair stable?

           yes                no

Does it allow movement?

           yes                no

Is the chair in a good state of repair?

           yes                no

If your chair has arms, do they get in the way?

           yes                no



6. Desk

Is the desk surface large enough to allow you to place all your equipment where

you want it?

           yes                no

Is the height of the desk suitable?

           yes                too high                   too low

Does the desk have a matt surface? (non-reflectant)?

           yes                no



7. Footrest

If you cannot place your feet flat on the floor whilst keying, has a footrest

been supplied?

           yes                no



8. Document Holder

If it would be of benefit to use a document holder, has one been supplied?

           yes                no

If you have a document holder, is it adjustable to suit your needs?

           yes                no





DISPLAY SREEN EQUIPMENT
------------------------

9. Display Screen

Can you easily adjust the brightness and the contrast between the characters on

screen and the background?

           yes                no

Does the screen tilt and swivel freely?

           yes                no

Is the screen image stable and free from flicker?

           yes                no

Is the screen at a height which is comfortable for you?

           yes                no



10. Keyboard

Is the keyboard separate from the screen?

           yes                no

Can you raise and lower the keyboard height?

           yes                no

Can you easily see the symbols on the keys

           yes                no

Is there enough space to rest your hands in front of the keyboard?

           yes                no



11. Software

Do you understand how to use the software?

           yes                no



12. Training

Have you been trained in the use of your workstation?

           yes                no

Have you been trained in the use of software?

           yes                no

If you were to have a problem relating to display screen work, would you know

the correct procedures to follow?

           yes                no

Do you understand the arrangements for eye and eyesight tests?

           yes                no





Any other comments?___________________________________________________________

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Reproduced with kind permission from Croner's Display Screen Equipment Handbook

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