A M Water Services Forms

DSE Self-Assessment

AMWS — DSE Self-Assessment (FORM_DSE_01)

Display screen equipment self-assessment for office workers.

This field is for validation purposes and should be left unchanged.

AMWS — DSE Self-Assessment (FORM_DSE_01)

HSE display screen equipment self-assessment for office workers. Complete annually or when workstation changes.

Document ReferenceFORM_DSE_01 — DSE Self-Assessment
Issue Number1
Issue Date12 May 2026
Next Review12 May 2027
Controlled BySean Ashton (HSQE Consultant, Onyx Operations)
Approved ByAaron Mason, Managing Director
StatusNew controlled document — supports POL_HSQE_25.
DD slash MM slash YYYY

Workstation

Tick Yes if the statement is true.

My chair has adjustable height, back support, and 5-pronged base
I can adjust my chair so feet are flat on floor (or footrest)
Top of screen is at or just below eye level
Screen is roughly an arm's length away
Keyboard is separate from screen with space to rest wrists
Mouse is within easy reach
Document holder used if frequently copying from paper
Lighting comfortable — no glare on screen
Sufficient legroom under desk
Desk surface large enough for equipment

Work pattern

Do you regularly take short breaks away from the screen (e.g. 5 minutes every hour)?
Do you alternate screen tasks with non-screen tasks?
Are you taking advantage of the company's free eye-test entitlement for DSE users?

Health symptoms

Sore / dry eyes
Headaches
Neck or back pain
Wrist / arm pain or tingling
Clear Signature