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Ergonomic assessment checklist template

Ergonomic assessment checklist template

A comprehensive template for identifying workplace ergonomic hazards that evaluates workstations, tasks, and equipment to prevent musculoskeletal disorders and improve employee comfort.

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The Lumiform application helps frontline teams uphold internal standards effortlessly.
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  • Get reports and analyse your data
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Ergonomic assessment checklist template

A comprehensive template for identifying workplace ergonomic hazards that evaluates workstations, tasks, and equipment to prevent musculoskeletal disorders and improve employee comfort.

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

Take control of workplace safety with our ergonomic assessment checklist that helps identify and mitigate risks before they lead to injuries. This template guides you through a systematic evaluation of workspaces, equipment, and task procedures to pinpoint ergonomic hazards that could cause musculoskeletal disorders.

With sections covering posture, repetitive motions, workplace layout, and environmental factors, you can thoroughly document problem areas and prioritize improvements. Recent data shows that musculoskeletal disorders account for nearly one-third of all workplace injuries requiring time away from work, making this assessment tool essential for any safety-conscious organization looking to protect employees and reduce workers’ compensation costs.

Related categories

  • Health and safety management templates
  • General templates
  • Workplace safety templates
Preview of the template
Page 1
Workstation Setup
Is the chair height adjusted so that thighs are parallel to the floor and feet are flat on the floor or footrest?
Is the backrest providing good lumbar support?
Is the seat pan depth appropriate (2-4 fingers between the back of the knee and seat)?
Is the desk/work surface at a comfortable height (elbow level)?
Is the monitor height adjusted so that the top third of the screen is at or slightly below eye level?
Is the monitor positioned directly in front of the user?
Is the monitor free of glare and reflections?
Is the keyboard and mouse within easy reach, with the wrists in a neutral position?
Work Practices
Does the user take regular breaks to stretch and move around?
Does the user avoid repetitive or awkward movements?
Does the user maintain good posture and avoid slouching?

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Related resources

Access a complete set of resources aimed at maximizing safety, quality, and operational excellence, including detailed guides, related templates, and real-world use cases.

Topic guides

Read in-depth guides covering key topics related to this article.

Ergonomics safety: Your essential guide to a thriving workplaceHazard identification: A guide for safer workplacesJob safety analysis (JSA): A comprehensive guideOccupational health and safety: A comprehensive guide
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Frequently asked questions

What specific areas does the ergonomic assessment checklist evaluate?

The checklist evaluates workstation setup (chair height, desk arrangement, monitor position), task requirements (repetitive movements, force exertion, awkward postures), tool design, environmental factors (lighting, temperature), and administrative controls. It provides a comprehensive framework to identify risk factors before they lead to musculoskeletal disorders.

How often should I conduct ergonomic assessments using this checklist?

Conduct assessments when setting up new workstations, after workplace modifications, when employees report discomfort, following injuries, or annually as preventive practice. Assess high-risk work areas or jobs with current ergonomic issues more frequently to catch problems early.

Who should be involved in completing the ergonomic assessment checklist?

Ideally, assessments should involve safety professionals, the affected employee, supervisors, and occasionally ergonomics specialists. Employee participation is crucial as they provide insights about discomfort, workflow challenges, and practical improvement suggestions that might not be obvious during brief observations.

What documentation should I gather before starting an ergonomic assessment?

Before assessment, collect incident reports, previous ergonomic evaluations, employee complaints, job descriptions detailing physical requirements, workplace layout diagrams, and equipment specifications. This background information helps identify patterns and focus your assessment on areas with known or potential issues.


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.
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