Ergonomic Workstation Assessment — Free Template

Assessment date

Employee name / workstation ID

Identify the workstation or the employee assigned to it.

Assessor name

Work area / department

Monitor top is at or slightly below seated eye level

Looking straight ahead, the user's eyes should meet the top third of the screen — not looking up to see the top. If the monitor is too high, the user must extend the neck backward; if too low, the user must flex the neck forward. Both increase MSD risk.

Monitor is at arm's length from the user (approximately 20–40 inches)

Have the user sit in normal posture and extend one arm toward the monitor — fingertips should nearly touch the screen. Closer than 20 inches increases eye strain; farther than 40 inches causes users to lean forward.

Monitor is directly in front of the user (no sustained neck rotation to view it)

Side-mounted monitors used as primary displays require constant neck rotation — a significant MSD risk factor. Secondary monitors are acceptable off-center if used intermittently.

Monitor tilted to minimize glare from windows or overhead lights

The user should not be directly facing a bright window. Tilt the monitor slightly back or reposition to reduce glare. Anti-glare screens are an alternative.

Work surface height allows forearms to be roughly parallel to the floor when typing

If the desk is fixed-height and too high, a chair raise or keyboard tray may be needed. If too low, the user rounds forward. Elbows should be close to the body at approximately 90 degrees.

Frequently referenced documents are held in a document holder between keyboard and monitor

Documents flat on the desk require repeated neck flexion. A document holder at near-monitor height reduces neck movement. Mark N/A if the employee rarely works from paper documents.

Photo — full workstation view from the side

Capture the user seated in normal posture with the monitor, keyboard, and chair all visible.

Notes on workstation setup

Lumbar support fills the natural inward curve of the lower back

Slide a hand between the user's lower back and the chair back — there should be minimal gap and the user should not be leaning forward to reach the keyboard. If the chair has adjustable lumbar, confirm it is positioned correctly.

2–4 inch gap between the front edge of the seat and the backs of the user's knees

A seat that is too deep forces the user to either lose lumbar contact or have the seat edge press into the back of the knees, reducing circulation. This gap check is one of the most commonly failed items.

Armrests (if present) support the elbows at or near typing height without raising the shoulders

Armrests should not force the shoulders up or push the arms away from the body. If armrests prevent the user from getting close enough to the keyboard, they should be lowered, removed, or left unused. Mark N/A if the chair has no armrests.

Chair is stable and in good mechanical condition (wheels, seat adjustment, back tilt all functional)

A chair that does not hold its adjustment or has broken wheels forces compensatory postures.

Notes on chair and seating

Wrist rest used only during pauses, not while actively keying

Resting weight on a wrist pad while typing compresses the carpal tunnel. Wrist rests are for rest periods only. Mark N/A if no wrist rest is present.

Mouse is positioned immediately next to the keyboard at the same level — no reaching required

Overreach to a mouse positioned far from the keyboard is one of the most common upper-extremity risk factors. The mouse should be at the same height as the keyboard and within easy reach without extending the elbow away from the body.

Mouse grip is relaxed — user is not pinching or gripping tightly

A tight mouse grip increases forearm muscle tension. The mouse should rest in the palm of the hand with fingers lightly on the buttons.

Phone use does not require cradling the handset between ear and shoulder

Shoulder-cradling a phone while typing is a significant lateral neck deviation risk. A headset or speakerphone should be used for calls lasting more than a minute or that occur while typing. Mark N/A if the employee does not use a deskphone.

Notes on input devices

No significant glare or reflections on the monitor screen

Check from the user's normal seated position. Sources: overhead lights, windows, bright walls. Solutions: blinds, monitor repositioning, anti-glare screen, hood.

Task lighting available for paper-based work if the ambient lighting is insufficient

Mark N/A if the employee works primarily on screen with minimal paper documents.

Workstation area is clear of trip hazards and cables are managed

Cable tangles under the desk can prevent full seat adjustment and foot positioning. Power cables crossing walkways are a separate safety concern.

Notes on lighting and environment

Shoulders are relaxed and not elevated or rounded during work

Hunched or elevated shoulders indicate the workstation height or reach may be wrong. Look for shoulder blade position and whether the user appears to be 'reaching' rather than resting.

Employee takes brief micro-breaks (at least 1–2 minutes) every 30–60 minutes of sustained computer work

Micro-breaks include looking away from the screen, standing, stretching, or walking briefly. Sustained static posture without breaks is a significant cumulative MSD risk factor regardless of how correct the workstation setup is.

Employee is aware of stretching exercises or has been offered ergonomic training

Check whether the organization provides stretch-break guidance, a wellness program, or ergonomic orientation. Awareness does not require a formal program — even a posted stretch guide counts.

Employee has reported any musculoskeletal discomfort (pain, numbness, tingling) related to this workstation?

This is a symptom screen, not a medical assessment. If Yes, the employer should refer the employee to occupational health or a qualified ergonomic professional for a more detailed evaluation.

Location and description of reported discomfort

Examples: 'neck pain at end of day', 'right wrist numbness when typing', 'lower back stiffness after 2+ hours seated'.

Notes on work habits and posture

Top 1–3 priority recommendations

List the highest-impact changes the employee or employer should make. Be specific: 'Raise monitor 3 inches' is better than 'Adjust monitor'.

Referral to occupational health or ergonomic specialist recommended?

Recommend referral when: the employee has active symptoms, the workstation has significant unresolved risk factors, or adjustments alone cannot resolve the identified hazards.

Target date for follow-up / re-assessment

Recommended: 30 days after changes are implemented, or sooner if symptoms are present.

Assessor signature

Employee acknowledgment signature

Employee confirms they have reviewed the assessment findings.