DSE Assessment
DSE Assessment
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HEALTH QUESTIONNAIRE
10. Do you experience any symptoms as a result of working at your workstation?
Yes
/
No
Physical
Visual
Stress
Red
Yellow
Green
Red
Yellow
Green
Assessors recomendations or advice
11. Please provide details of the above symptoms.
12. Has this been reported to your employer?
Yes
/
No
Advised?
Red
Yellow
Green
Red
Yellow
Green
Assessors recomendations or advice
13. Have you sought medical advice?
Yes
/
No
Recommended
Red
Yellow
Green
Red
Yellow
Green
Assessors recomendations or advice