Follow the steps to complete the form online

1. Click ‘Get Form’ button to obtain the Self Assessment and Ergonomic Equipment Request Form and open it in your preferred editor.
2. In Part A – Self Assessment, evaluate your seated body posture while keyboarding by answering the questions with YES or NO based on your current ergonomic setup.
3. Continue filling out Part A by assessing your office deskchair and keyboard tray, again answering each question with YES or NO.
4. In Part B – Equipment Request, select the items you wish to request by checking the appropriate boxes for office deskchair, adjustable keyboard/mouse tray, or wrist rest (gel pad for keyboard tray).
5. Complete the personal information section in Part B, including your name, office room number, extension, email, and department.
6. Part C will be filled out by the Dean, VP Academic, and LUFA President or their designate during the recommendation and approval process.
7. Once all sections are complete, ensure to save your changes. You can then download a copy of the form to print or share as necessary.

Start completing the Self Assessment and Ergonomic Equipment Request Form online today!