Computer Workstation Checklist
Evaluator _________________

Date of Evaluation (mm/dd/yy) ____/____/____
WORK

1. How many hours per week, on average, is the computer used at work?
Less than 10 hours
10-19 hours
20-29 hours
30 hours or more
2. How many hours per week, on average, is the computer used at home?
Less than 10 hours
10-19 hours
20-29 hours
30 hours or more
3. Is the computer ever used for more than 50 hours per week?

Y

N

4. In a typical workday, what is the longest time worked continuously on the computer
without switching to non-computer work or taking a break of more than a few
minutes?
less than 1 hour
1 hour or more
5. Is the workstation routinely shared with someone else?

Y

N

6. What is the nature of the work done on the computer? Check all that apply.
Continuous Data Entry or
Transcription (e.g. words
or numbers)

Composing Written Documents

Graphics Intensive Work
(e.g. heavy mouse use)

Intermittent Input/Retrieval
(e.g. accessing databases or other files)
EYES

7. Circle the letter next to the pictures which best illustrate head and neck posture
when working at the computer. Check more than one if the person is often in
that position. The heavy dashed line indicates the line of the neck:
Visual Targets
_____________
_____________
_____________
_____________
_____________
_____________

The visual target is what is being looked at in each position selected (e.g. documents, screen).

2002 University of California, San Francisco, Ergonomics Program (1-8-02)

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8. Check the picture that shows how the head is usually held when working at
the computer. Check more than one if often in those positions.
List the visual targets in each position (e.g. documents, keyboard, screen).

Straight ahead
Visual target

_________

To the right
_________

To the left
________

9. Is there glare or reflection from other light sources on the monitor?
N
Y
Sources of glare: ________________________
10. Is it necessary to lean forward to clearly see the characters on the computer
screen?
Y
N
HANDS
11. Check the areas where the arms are supported most of the time while using
the keyboard (left and right arm) and the mouse.
L

R
While Using the Keyboard

While Using the
Mouse/Trackball

12. Indicate the most common position of the shoulders when using the keyboard,
mouse, or doing paperwork. For each task, check the most appropriate image.
The heavy dashed line indicates the position of the arm.

2002 University of California, San Francisco, Ergonomics Program (1-8-02)

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13. Indicate the most common position of the elbows when using the keyboard or
mouse. For each task, circle the letter next to the appropriate image.

14. Is the arm or hand frequently resting on any narrow (< 2" wide) or sharp surface?
Y
N
15. Circle the letters next to the pictures best describing the usual wrist position
when working at the computer. Check more than one if the person is
often in that position. The heavy lines indicate the angle of the wrist:

16. When typing at the computer, are the fingers or wrists flicked to
reach side keys as shown by the shaded hand in the drawings below?
o Never
o Sometimes
o Frequently
17. Check the picture that best represents the wrist position when working at
your computer. The heavy lines indicate the angle of the wrist.
2002 University of California, San Francisco, Ergonomics Program (1-8-02)

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L

R

A

L

R

L

B

R

C

18. If a mouse or other pointing device is used, are dragging operations performed
(i.e., moving or holding the mouse with the button held down such as when using
scroll bars,highlighting text, or resizing graphics)? Yes
No/Rarely
19. If a telephone is used while typing on the computer, how is the receiver held?
A headset or speakerphone is used.
The telephone is cradled between the shoulder and ear.
The receiver is held with one hand while the other hand writes or uses the keyboard.
BODY
20. Lumbar or other extra cushions in use?

Y

N

21. Circle the letter corresponding to the picture that best illustrates back posture at the
computer. Check more than one if that position is used often. The heavy
dashed line indicates the shape of the spine.

22. While working at the computer, where is the back supported by the chair?
Please circle the appropriate letters.
2002 University of California, San Francisco, Ergonomics Program (1-8-02)

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23. When working at your computer, what supports your feet?
The floor

A footrest

Base of chair

Nothing/Feet dangling

24. Check the picture that shows the commonly used sitting position at work. Check
more than one picture if often in that position. The heavy straight line
indicates the angle of the thigh.

25. When working at or around the computer to reach for documents or use
the telephone, can the body and chair be moved comfortably without hitting
or bumping into anything?
Y

N

What is bumped into? __________________
__________________

2002 University of California, San Francisco, Ergonomics Program (1-8-02)

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