Excuse the mess, while our site undergoes renovations!
Request for Ergonomic Screens

  1. These are best for non-complex early intervention or chronic conditions. Our consultants can conduct in person or virtually via telephone or video call (WhatsApp, WebEx, or Zoom phone apps preferred).

    Our consultants call your employees to evaluate their workstation and suggest immediate adjustments for the highest risk conditions. Typically 3 issues (maybe 4) can be addressed. Within 10 business days after the end of a month, we will deliver an aggregated spreadsheet that identifies each employee’s general concerns, and additional recommendations for you to follow-up on, if there are any. Depending on volume, we will either schedule person by person, or provide you an on-line calendar for employees to self-select. Please Note: For those who end up having complex issues, a 2nd virtual appointment may be required.

  2. Please enter your contact information here.
  3. Company(*)
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  4. Your Name(*)
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  5. Your E-mail(*)
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    Please ensure that there are NO ADDITIONAL SPACES either before or after the email address. Additional spaces will cause an invalid response.
  1. Please enter the employees information below..
  2. Facility Address
    Please enter the facility name and address.
  3. 1. Full Name(*)
    Please type the first employee's full name.
  4. Screening is for(*)
    Please tell us if this employee's assessment should be in-person or via telephone.
  5. Assessment should be(*)
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  6. Telephone(*)
    Please enter a 10 digit phone number. XXX-XXX-XXXX
  7. E-mail(*)
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  8. 2. Full Name
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  9. Screening is for
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  10. Assessment should be
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  11. Telephone
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  12. E-mail
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  13. 3. Full Name
    Please type the first employee's full name.
  14. Screening is for
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  15. Assessment should be
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  16. Telephone
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  17. E-mail
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  18. 4. Full Name
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  19. Screening is for
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  20. Assessment should be
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  21. Telephone
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  22. E-mail
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  23. Comments / Additional Information:
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  24. (*)
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  25. If you have entered all requests please Submit. Otherwise please continue to the next page
  1. Please enter the employees information below..
  2. 5. Full Name
    Please type the first employee's full name.
  3. Screening is for
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  4. Assessment should be
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  5. Telephone
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  6. E-mail
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  7. 6. Full Name
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  8. Screening is for
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  9. Assessment should be
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  10. Telephone
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  11. E-mail
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  12. 7. Full Name
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  13. Screening is for
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  14. Assessment should be
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  15. Telephone
    Please enter a 10 digit phone number. XXX-XXX-XXXX
  16. E-mail
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  17. 8.Full Name
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  18. Screening is for
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  19. Assessment should be
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  20. Telephone
    Please enter a 10 digit phone number. XXX-XXX-XXXX
  21. E-mail
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  22. Comments / Additional Information:
    Please enter the facility name and address.