University of California, Riverside

Ergonomics



Laboratory Evaluation


Instructions: Use this form to request an Ergonomic Evaluation of your Laboratory Workstation. All fields are required to be completed. This service is available to employees only.

Name:
Phone Number:
Email Address:
Department:
Job Title:
Supervisor:
Type of Request: Ergonomic workstation evaluation
Seating evaluation
Information and demonstration of ergonomic laboratory equipment
Reason(s) for request: I experience discomfort (associated with my workstation)
I have a new workstation or I am new to the job
I want to ensure my workstation is set up ergonomically correct
Other (please specify)*
Please identify your primary work tasks: (check all that apply) Benchwork
Hand Tool Use
Microscope work
Pipetting
Test Tube Handling
Other (please specify)*
Comments? (optional)
     

For assistance with this form, please contact Ergonomics (951) 827-3010.

More Information 

General Campus Information

University of California, Riverside
900 University Ave.
Riverside, CA 92521
Tel: (951) 827-1012

Department Information

Human Resources
1201 University Ave., Suite 208
Riverside,CA 92507


Fax: (951) 827-2672

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