JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Discomfort Survey
Section 1 of 3
Please fill out this survey to help us identify any discomfort you may be experiencing at your home office workstation. This can help us prioritize the need for a Virtual Ergonomic Assessment, making your job safer, improving both your comfort and productivity.
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Email
*
Your email
First Name
*
Your answer
Last Name
*
Your answer
How many hours do you work per day?
*
Your answer
In a typical workday, what are your main tasks (e.g., phone calls, spreadsheet, word processing), and how many minutes/hours do you spend performing them?
*
Your answer
Next
Page 1 of 3
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.
Report Abuse
-
Terms of Service
-
Privacy Policy
Forms
