Ergonomic Questionnaire

Virtual Ergonomic Assessment for Workstations

Fill out this questionnaire and upload three photos of your work area including your chair, workstation, and equipment you are working with. Our manager of ergonomic programs, will contact you to schedule a teleconference to review his recommendations for your workstations and your action plan. Following your teleconference, we will complete a brief ergonomic analysis report and forward a copy to you and your employer.

Step 1 of 3

Is this regarding a current work comp claim?(Required)