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DSE assessment template

DSE assessment template

Use this DSE assessment form to evaluate workstation ergonomics and identify health risks for display screen users.

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DSE assessment template

Use this DSE assessment form to evaluate workstation ergonomics and identify health risks for display screen users.

Use this template with Lumiform

The Lumiform application helps frontline teams uphold internal standards effortlessly.
  • Customize this template or build your own
  • Fill out templates via mobile app
  • Assign and track corrective actions
  • Get reports and analyse your data
Prices start from ░░░ per month
Book a demo
Learn more
or Download template as PDF

Our DSE assessment template helps you evaluate workstations and identify potential health risks for employees who regularly use display screen equipment. It aids you in complying with the Health and Safety (Display Screen Equipment) Regulations, which require employers to assess and reduce risks for DSE users.

Research shows that more than 50% of office workers experience neck pain, with shoulders and lower back also commonly affected by poor workstation setup. With comprehensive sections covering screens, furniture, input devices, and work environment, this template enables you to quickly identify issues and implement corrective measures before they lead to musculoskeletal disorders or visual fatigue among your team.

Related categories

Preview of the template
Personal Information
Name
Department
Location of Workstation
Reason for Assessment
Your Daily Routine
Do you have any problems with your hands, wrists, arms, shoulders, neck or back?
Do you suffer from visual fatigue or headaches?
Screen
Are characters readable?
Is the image free of flickering and movement?
Is the screen free from glares and reflections?
Furniture
Is the large surface large enough for work equipment (monitor, keyboard, documents)?
Are you sitting comfortably? (Suppported by chair, eye-level slightly below DSE screen?)
Is the chair stable?
Do adjustment mechanisms work?
Keyboard & Mouse
Is the keyboard tiltable?
Is there enough space to rest hands in front of keyboard?
Are characters and keys easy to read?
Does the mouse fit comfortably in one hand?
Does the mouse move easily and respond appropriately?
Work Environment
Are levels of light, heat and noise comfortable?
Is the workstation area free from hazards?
Further notes and concerns.
Sign Off
Date & Time
Signature
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Frequently asked questions

What actions should you take after completing a DSE assessment?

After identifying issues, prioritize them based on risk level and implement corrective measures promptly. This might include adjusting equipment, providing accessories like footrests or wrist supports, arranging eye tests, or offering ergonomic training. Document all actions taken and schedule follow-up assessments.

How do you assess if a chair is properly adjusted for DSE work?

Check that the user’s feet rest flat on the floor (or on a footrest), knees are at approximately 90 degrees, lower back is supported by the chair’s lumbar support, and arms are parallel to the desk when typing. The chair should be stable and all adjustment mechanisms should work smoothly.

What should you do if an employee reports headaches during DSE assessment?

First, check screen positioning—it should be at eye level and arm’s length away. Assess lighting for glare or reflections on the screen. Evaluate if the user takes regular breaks. Consider recommending an eye test, as headaches can indicate vision problems. Document these concerns in the assessment’s notes section.

How do you assess DSE needs for employees with existing health conditions?

Take extra care to understand their specific requirements by consulting with occupational health professionals if available. Document their condition in the assessment’s notes section, consider reasonable adjustments like specialized equipment, and schedule more frequent follow-up assessments to monitor effectiveness of interventions.

This template, developed by Lumiform employees, serves as a starting point for businesses using the Lumiform platform and is intended as a hypothetical example only. It does not replace professional advice. Companies should consult qualified professionals to assess the suitability and legality of using this template in their specific workplace or jurisdiction. Lumiform is not liable for any errors or omissions in this template or for any actions taken based on its content.