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Ergonomic Equipment/Training Declination Form

by Jeff Jones, from the Community

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Official declination form for the New Jersey Motor Vehicle Commission ergonomics program. Use to record when an employee refuses ergonomic equipment or training, capture reasons, note workstation availability, and secure employee, evaluator, and manager signatures. Includes acknowledgment of potential Workers' Compensation effects and contact for the MVC Office of Health and Safety.

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Digitize any process, procedure or policy
Eliminate mistakes made by paper-based processes
Create and share professional reports instantly
Confirm accountability and compliance with a digital log

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This community page makes available free workplace checklists and templates created by other users within the SafetyCulture community. SafetyCulture has re-published this content and where possible, has credited the original author. SafetyCulture has not verified the accuracy, reliability or suitability of any community content. You agree that your use of any of this content is in accordance with SafetyCulture’s Terms and Conditions.