1. Relevant medical history or complaint e.g please state whether you have any MSK issues, aches or pains:
2. Do you have any current issues with your work desk space, work area, or equipment? Please specify.
3. Do you any postural issues or problems e.g. spinal issues? This does not have to be a diagnosed issue. Please specify
4. What is your job role? Give a brief description of your daily roles.
5. Are you pregnant?
6. What are your height (cm) and weight (kg)?
This question is to ensure you have the suitable chair for your height or weight.
7. Do you: (tick one or more that applies to you)
8. Apart from your usual work-space, do you have any other desks, tables or equipment you use for work? Please state what you use.
9. How do you get to/from work, how long is your commute and what do you do during your commute i.e read a book? (if applicable). Alternatively, if you are a remote worker, what is your transport method, and what do you do when travelling?
10. How many breaks do you take during the day?
11. How many micro-breaks do you take during the day? (examples of a micro-break include: making a coffee, talking to a colleague or standing up to stretch).
12. Average hours worked in a day (including out of hours work):
13. On a scale of 1-10, how stressed do you feel at work? Please select.
14. Are you happy with the following in your workspace? Please tick.
15. Please justify any answers in Q9 that have not been ticked?
16. How many screens do you use at one time (including laptop). If more than one, please state the type of screens you use and how often.
17. How often do you use a telephone or mobile phone as part of your job? Please also state whether you use a headset or earphones for either?
18. How often do you use your mobile for work i.e emails?
19. Any other relevant information?
Please note: we may contact you by email or phone if we have further questions or queries.
Please insert below a clear picture of your workstation. The image or video should clearly show your desk, chair, and the area surrounding your desk/workspace, ideally as much space that surrounds your desk, as possible.
Finally, please insert below a picture of yourself, working at your desk (even if you need to pretend!). Please make this look as realistic as possible. For example, if your job involves answering calls most of the time, please can your image include you showing this.
If images or videos are not clear enough, we may have to ask you to re-take this for us.
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