Seating Assessment Form

Date
Company Name
Contact Name*
Address
Email*
Address2
Contact Number*
Address3
Please provide a description of any musculoskeletal disorder and any previous injuries to your spine. Please comment on any back pain experiences while seated and what makes that pain better or worse?
Description*
Dimensions
Weight (Stone/kilos)
Height (feet and inches)
A. Height of lumbar above seats
Would you like arms on the chair?
B. Back of knee joint to floor
Desk shape: rectangle (R), corner (C) or wave (W)
C. Back of buttock to back of knee
Floor: Type: Wood, Carpet, Concrete, Etc
D. Seat surface of shoulder
E. Hip to hip
F. Shoulder width
G. Desk height
GDPR Accepted On
- Please tick for us to be able to contact you in the future about our services. Privacy Policy.
Phone
This field is for validation purposes and should be left unchanged.

Online Seating Assessment Form
Date
Company Name
Contact Name*
Address
Address2
Address3
Email*
Contact Number*
Please provide a description of any musculoskeletal disorder and any previous injuries to your spine. Please comment on any back pain experiences while seated and what makes that pain better or worse?
Description*
Dimensions
Weight (Stone/kilos)
Height (feet and inches)
Would you like arms on the chair?
Desk shape: rectangle (R), corner (C) or wave (W)
Floor: Type: Wood, Carpet, Concrete, Etc
A. Height of lumbar above seats
B. Back of knee joint to floor
C. Back of buttock to back of knee
D. Seat surface of shoulder
E. Hip to hip
F. Shoulder width
G. Desk height
GDPR Accepted On
- Please tick for us to be able to contact you in the future about our services. Privacy Policy.
Phone
This field is for validation purposes and should be left unchanged.

Dimensions