Display Screen Equipment (DSE) Assessment Form Template

The DSE workstation assessment form can be used by employers who need to comply with the Health and Safety (Display Screen Equipment) Regulations 1992. It lists risk factors in six areas, with "yes/no" tick boxes: keyboards, mouse and trackball, display screens, software, furniture, and work environment. It also lists issues to consider and provides a space to record planned action. This template is based on the Health and Safety Executive Northern Island's (HSENI) DSE Workstation Assessment Checklist.The DSE workstation assessment form can be used by employers who need to comply with the Health and Safety (Display Screen Equipment) Regulations 1992. It lists risk factors in six areas, with "yes/no" tick boxes: keyboards, mouse and trackball, display screens, software, furniture, and work environment. It also lists issues to consider and provides a space to record planned action. This template is based on the Health and Safety Executive Northern Island's (HSENI) DSE Workstation Assessment Checklist.