Safety | Human Resources | University of Salford - A Greater Manchester University

Display Screen Equipment (DSE) Assessment Form

For guidance on completing this form, discuss with your line manager. To help complete your assessment refer to this diagram.
Select answers Yes or No. Yes answers require no further action but for No answers, refer to the guidance on the right hand column
You will receive a copy of this form and so will your H&S coordinator.

Your name:
Your email address:
Your unit:
Office location:
Line manager:
Type of work:
Date of assessment:

1.0	Your chair
1.1	Is the chair stable, supportive and adjustable?	If no request new chair
1.2	Have you adjusted the chair?	For guidance see diagram
1.3	After adjustment can you sit with your feet flat on the floor?	Discuss with line manager you may need footrest
1.4	Does the backrest adjust in both height and tilt?	Discuss with line manager
1.5	Have you adjusted the back rest to yourself?	See diagram
1.6	Can you adjust or remove the arms of your chair if needed?	Discuss with line manager
2.0	Your Desk
2.1	Does the work surface have enough space to fit your computer, keyboard and mouse?	Re-organise your desk space. Discuss with your line manager a new desk may be required
2.2	Can the screen be viewed without twisting neck and back?	Re-position
2.3	If you require a document holder is one provided?	Discuss with your line manager consider purchasing
3.0	Your Keyboard
3.1	Is there space to rest your hands in front of keyboard when not typing?	See diagram - consider repositioning keyboard
3.2	Can you read the keys on the keyboard?	Discuss with your line manager. A new keyboard may be required
3.3	Is the keyboard separate from the computer and screen?	Provide separate keyboard
4.0	Your Screen
4.1	Are the characters clear and readable?	Check the screen is clean and clean it at regular intervals
4.2	Is the image stable i.e. free of flicker and jitter?	Adjust colours and background to reduce flicker, if no improvement discuss with your line manager. Equipment may need checking by a technician
4.3	Is the screen adjustable?	Discuss with your line manager consider purchasing swivel/tilt mechanism
4.4	Is the screen free from glare and reflections?	Consider moving screen or desk. Adjust window coverings, if problem persists discuss with your line manger.
5.0	Your Mouse or Trackball
5.1	Is the device suitable for the task it is used for?	Discuss with your line manager consider purchasing an alternative device
5.2	Is there room to use the mouse without stretching arms or bending wrists?	Re-arrange desk and/or discuss with your line manager, a wrist support may be required
5.3	Does the device work smoothly and at a speed that suits the user?	Check if cleaning is required. Check the work surface. Consider purchasing a new device
6.0	Your Environment
6.1	Is there space for you to change position and vary movements?	Consider rearranging furniture to ensure access and position is optimum.
6.2	Is the lighting of the room adequate?	Discuss with line manager and report specific problems to H&S Coordinator
6.3	Is there blinds or coverings on windows to control glare as needed?	Discuss with line manager, additional blinds may be required.
6.4	Is the environment and equipment free from excessive noise?	Discuss with line manager and report specific problems to H&S Coordinator
6.5	Is the temperature and humidity acceptable most of the time?	Discuss with line manager and report specific problems to H&S Coordinator
7.0	About you
7.1	Can you confirm (YES) that you are not experiencing other DSE problems ? [not identified above]
7.2	Can you confirm (Yes) you are not experiencing any symptoms or discomfort that you attribute to DSE activity? [i.e. back, wrist pain]
7.3	Have you been informed of your entitlement to an eye test?	Refer to DSE code of Practice for further information.
8.0	Additional Information
	Please use this space to add any corrective actions required or completed, if you have answered NO to any of the assessment questions. Please do not include any confidential information and use no more than 250 characters. Characters remaining A value is required. Exceeded maximum number of characters.