Remote Laboratory Ergonomic Evaluation Completion of the checklist below will help us to determine if your workstation is properly set up. At the bottom of this online form, we request you upload two (2) pictures of yourself seated or standing at your desk or lab station (working) – with as much of your body and workstation in the shot as possible. (You may also email pictures to ErgonomicWorks with your full name and "laboratory ergonomic evaluation" in the subject line.) If we need any clarification we will either call you or email you directly. We look forward to working with you! Name: Phone Number: Email Address: Job Title: Type of Request Ergonomic workstation evaluation Seating evaluation Information and demonstration of ergonomic workstation equipment 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)* Are you able to avoid a rounded or hunched shoulder posture when using the microscope? YES NO N/A Are you able to maintain a relatively neutral neck position (no more than 25°of forward bending)? YES NO Is contact pressure between your forearm and hard surfaces or sharp edges avoided or padded? YES NO Is the microscope position at the near edge of the bench or work surface? YES NO N/A Is there sufficient leg room when you’re seated? YES NO Are your feet supported by the floor or a footrest? YES NO Are regularly-used supplies within easy reach? YES NO Please type any additional information in below box Please upload your ergonomic picture here. Almost finished! When you click the Submit button below, you’ll be directed to a secure payment page. Again, the cost of an Ergonomicworks remote laboratory ergonomics evaluation is $220.