| OK | Needs Help | N/A | Checklist Issue |
| Are workstations carefully designed to fit individual workers? | |||
| Are employees performing tasks that require prolonged raising of the arms, pressure points on the wrists, forearms given sufficient rest breaks to relieve stress from repetitive motions? | |||
| Are employees and supervisors trained in how to keep their workstations ergonomically sound and efficient? | |||
| Are all work areas well illuminated? | |||
| Are there procedures/programs/methods in place to effectively handle employee complaints of symptoms related to musculoskeletal disorders? |
Checklist Completed By _____________________________________
Checklist Completion Date ___________________________________
Note: Document all follow-up actions necessary and taken to ensure the maximum level of worker health and safety.
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