Ergonomic Assessment Form

Online Ergonomic Assessment Request

MM slash DD slash YYYY
Name(Required)
Please enter a number from 0 to 115.

Please answer the following:

Do you experience musculoskeletal discomfort that you feel is related to your work tasks?(Required)
How long has it been since you started to experience this discomfort?(Required)
How often do you experience the discomfort?(Required)
Do you feel discomfort(Required)
How did the discomfort begin?(Required)

Select the specific part(s) of your job that is of concern to you:

Workplace
Work/Job
Office Tools
Materials Handling
Environment
This field is for validation purposes and should be left unchanged.

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Questions?

Need to report an unsafe condition or incident?

Phone: 336.758.EHAS (3427)
Email: wfuehs@wfu.edu
Office Location: The EHS building is in the Facilities Compound on Wingate Road. It is the last building on the left up from Fleet Services, next door to Landscaping.