1. Personal Details
Your Title
Your Full Name
Your Email
Phone Number
Your Age
Height (Feet)
Height (Inches)
Weight (Stone)
Weight (Lbs)
Your Gender
2. Job Role & Working Hours
Please describe your job role, and your contractual working hours per week (including daily lunch break)
3. Musculoskeletal Aches & Pains Do you suffer from any musculoskeletal aches and pains when working at your workstation? You can use this picture as a reference and add your comments, for example,
C1–C7 or L1-L5. Also, you can add other areas of pain, such as neck, shoulders, hand, arms, elbow, fingers, knees, legs (sciatica), and hips. Please provide more background
information on your aches and pain, which will help us to provide you with preventative measures and the effective recommendations for improvement.
4. Office Chair Answers will appear in the Office Chair section of your report.
5. Screen / Monitor Position Answers will appear in the Screen/Monitor Height and Depth Positioning section.
When was the last time you had your eyes examined?
6. Workstation Accessories
7. Workstation Environment
What is the shape of your desk edge?
What is the surface of your floor?
8. Workstation Photo Upload a clear photo of yourself working at your usual workstation, sitting exactly as you normally would, without adjusting your setup. The image should show your full workstation—including your chair, desk, screen, keyboard or laptop, and the position of your arms, hands, and feet—ideally capturing your whole body from head to toe. Take the photo from a side (profile) view, ensuring it is well-lit, in focus, and free from obstructions. Wear normal work attire that does not obscure your posture, and make sure only you are visible in the image. Avoid displaying any sensitive information on screens or documents. Before uploading, check that your workstation and posture are clearly visible, and the image quality is good; retake it if necessary.
9. Business & Employer's Details
Your employer's name (for invoice purpose only)
Your employer's full address (for invoice purpose only)
10. GDPR Compliance & Data Protection WellbeingandErgonomics are committed to ensuring the security and protection of the personal information that we process, and to providing a compliant and consistent approach to data protection. Your data and pictures submitted will not be shared with anyone, and they will only be used for producing your DSE Assessment report. We have always had a robust and effective data protection program in place, which complies with the existing law and abides by the data protection principles. These records will be held with TechDisinfect Limited T/A WellbeingandErgonomics in accordance with the GDPR and Data Protection Compliance.
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