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Run: Ergonomics Discomfort Survey

Use this ergonomics discomfort survey to pinpoint which body regions, tasks, and work areas are driving strain so you can prioritize fixes before injuries es...

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Work Area and Task Profile

Which work area or department do you primarily work in? (required)

Select the area where you spend the majority of your shift.

How long have you worked in your current role? (required)

Select the option that best describes your tenure in this position.

How many hours per shift do you typically work? (required)

Which physical tasks make up the majority of your shift? (Select all that apply) (required)

Check every task you perform regularly during a typical shift.

Yes No N/A

Body Region Discomfort — Upper Body

Neck and upper shoulders: How much discomfort have you experienced in the past 30 days? (required)

1 = No discomfort at all | 2 = Mild, occasional | 3 = Moderate, noticeable during or after work | 4 = Significant, affects my work pace | 5 = Severe, persistent pain

If you rated neck/upper shoulder discomfort 3 or higher, please describe when it occurs and what tasks seem to trigger it.

For example: 'Pain starts after 2 hours of overhead picking' or 'Stiffness when looking down at a packing station for long periods.'

Upper back (between shoulder blades): How much discomfort have you experienced in the past 30 days? (required)

1 = No discomfort at all | 2 = Mild, occasional | 3 = Moderate, noticeable during or after work | 4 = Significant, affects my work pace | 5 = Severe, persistent pain

Shoulders (left, right, or both): How much discomfort have you experienced in the past 30 days? (required)

1 = No discomfort at all | 2 = Mild, occasional | 3 = Moderate, noticeable during or after work | 4 = Significant, affects my work pace | 5 = Severe, persistent pain

If you rated shoulder discomfort 3 or higher, please describe when it occurs and what tasks seem to trigger it.

For example: 'Aching after pulling heavy pallets' or 'Sharp pain when reaching into high shelving.'

Elbows and forearms: How much discomfort have you experienced in the past 30 days? (required)

1 = No discomfort at all | 2 = Mild, occasional | 3 = Moderate, noticeable during or after work | 4 = Significant, affects my work pace | 5 = Severe, persistent pain

Wrists and hands (including fingers): How much discomfort have you experienced in the past 30 days? (required)

1 = No discomfort at all | 2 = Mild, occasional | 3 = Moderate, noticeable during or after work | 4 = Significant, affects my work pace | 5 = Severe, persistent pain

If you rated elbow, wrist, or hand discomfort 3 or higher, please describe when it occurs and what tasks seem to trigger it.

For example: 'Tingling in fingers after hours of scanning' or 'Wrist pain when taping boxes repeatedly.'

Body Region Discomfort — Lower Body and Back

Lower back: How much discomfort have you experienced in the past 30 days? (required)

1 = No discomfort at all | 2 = Mild, occasional | 3 = Moderate, noticeable during or after work | 4 = Significant, affects my work pace | 5 = Severe, persistent pain

If you rated lower back discomfort 3 or higher, please describe when it occurs and what tasks seem to trigger it.

For example: 'Stiffness after lifting floor-level totes for 3+ hours' or 'Pain when twisting to place items on conveyor.'

Hips and buttocks: How much discomfort have you experienced in the past 30 days? (required)

1 = No discomfort at all | 2 = Mild, occasional | 3 = Moderate, noticeable during or after work | 4 = Significant, affects my work pace | 5 = Severe, persistent pain

Knees: How much discomfort have you experienced in the past 30 days? (required)

1 = No discomfort at all | 2 = Mild, occasional | 3 = Moderate, noticeable during or after work | 4 = Significant, affects my work pace | 5 = Severe, persistent pain

If you rated hip or knee discomfort 3 or higher, please describe when it occurs and what tasks seem to trigger it.

For example: 'Knee soreness after kneeling to pick bottom-shelf items' or 'Hip aching after long walking routes.'

Feet, ankles, and lower legs: How much discomfort have you experienced in the past 30 days? (required)

1 = No discomfort at all | 2 = Mild, occasional | 3 = Moderate, noticeable during or after work | 4 = Significant, affects my work pace | 5 = Severe, persistent pain

If you rated foot, ankle, or lower leg discomfort 3 or higher, please describe when it occurs and what tasks seem to trigger it.

For example: 'Foot fatigue after 10-hour shifts on concrete' or 'Ankle soreness when climbing step stools repeatedly.'

Task and Workstation Risk Factors

The weights I am required to lift feel manageable without straining. (required)

1 = Strongly disagree | 2 = Disagree | 3 = Neither agree nor disagree | 4 = Agree | 5 = Strongly agree

My workstation or work area is set up at a comfortable height for my tasks. (required)

1 = Strongly disagree | 2 = Disagree | 3 = Neither agree nor disagree | 4 = Agree | 5 = Strongly agree

I am able to vary my posture or take brief rest breaks during my shift. (required)

1 = Strongly disagree | 2 = Disagree | 3 = Neither agree nor disagree | 4 = Agree | 5 = Strongly agree

Lift-assist equipment (carts, hoists, pallet jacks, etc.) is available and practical to use for my tasks. (required)

1 = Strongly disagree | 2 = Disagree | 3 = Neither agree nor disagree | 4 = Agree | 5 = Strongly agree

Which specific task or workstation do you believe poses the greatest physical strain risk in your area?

Be as specific as possible — e.g., 'Unloading floor-loaded trailers with no mechanical assist' or 'Packing station height is too low for associates over 5'8".'

Reporting, Support, and Open Feedback

I feel comfortable reporting discomfort or ergonomic concerns to my supervisor without fear of negative consequences. (required)

1 = Strongly disagree | 2 = Disagree | 3 = Neither agree nor disagree | 4 = Agree | 5 = Strongly agree

I am aware of the process for requesting an ergonomic evaluation or job task modification. (required)

1 = Strongly disagree | 2 = Disagree | 3 = Neither agree nor disagree | 4 = Agree | 5 = Strongly agree

Have you previously reported a discomfort concern or near-miss related to ergonomics? (required)

What one change to your work area, tools, or task design would most reduce your physical discomfort?

Your input directly shapes ergonomic improvement priorities. Please be specific — e.g., 'Anti-fatigue mats at the packing line' or 'Adjustable-height conveyor at the sort station.'

Is there anything else about ergonomics, physical demands, or your work environment you'd like us to know?

This survey is anonymous. All responses are reviewed by the safety team to improve working conditions.

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