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ERGONOMIC EQUIPMENT REQUEST FORM Name: Department/School: Year of Appointment at Laurentian Building: Room Number: Extension: E-mail Address ? Is there anything that needs to be removed from your
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How to fill out ergonomic equipment request form
How to fill out ergonomic equipment request form:
01
Start by gathering all the necessary information such as your personal details, job title, and department.
02
Identify the specific ergonomic equipment you require and describe it in detail, including the brand, model, and any special features.
03
Explain the reasons why you need the ergonomic equipment and how it will benefit your work performance and overall health.
04
If applicable, provide any medical documentation or recommendations from healthcare professionals supporting your need for the equipment.
05
Indicate any previous attempts to obtain ergonomic equipment and the outcome of those attempts, if applicable.
06
Specify any alternative solutions or accommodations that have been considered and explain why they are not feasible or suitable.
07
Sign and date the form, acknowledging that the information provided is accurate and complete.
Who needs ergonomic equipment request form:
01
Employees who experience discomfort, pain, or other ergonomic-related issues while performing their job.
02
Individuals who have a medical condition or disability that requires specific ergonomic equipment.
03
Employees who are proactive about preventing ergonomic-related injuries and improving their work environment.
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