Health and Safety

Preliminary Checklist for Pregnant Office Worker

Dublin City University Health & Safety Office
Preliminary Checklist for Pregnant Office Worker

NAME: DATE:
PHONE NUMBER: DOB:
JOB TITLE: LOCATION:
NAME AND ADDRESS OF YOUR FAMILY DOCTOR:  
HAVE YOU BEEN CERTIFIED PREGNANT: YES NO
WHAT IS YOUR DUE DATE:
HAVE YOU NOTIFIED YOUR SUPERVISOR/MANAGER YES NO
SUPERVISOR/MANAGER NAME:
CONTACT PHONE NUMBER

PRELIMARY JOB ASSESSMENT

Does your Job involve?

Working with a VDU YES NO
Manual Handling? YES NO
Night Work? YES NO

THE WORKING ENVIRONMENT - GENERAL

Do you work alone? YES NO
Do you have means of communicating in an emergency? YES NO
Are you aware of first aid arrangements? YES NO
Are you required to wear/provided with any personal protective equipment (PPE) YES NO
If YES list PPE provided:  

THE WORKING ENVIRONMENT - VISUAL DISPLAY UNITS

Does the task involve using a VDU? YES NO
Have you completed the web based VDU Risk Assessment on your workstation? YES NO
Have you attended the office ergonomic training programme? YES NO
Have you been provided with information on the safe use of VDUs? YES NO

THE WORKING ENVIRONMENT - MANUAL HANDLING

Do you routinely lift items weighing more than 10kg? YES NO
Have you undergone manual handling training? YES NO
Does your work involve periods in excess of 1 hour at a time sitting or standing? YES NO
Are you required to access ladders/platforms at height? YES NO
Do you wish the H&S Office to contact you regarding specific safety issues in pregnancy? YES NO
DCU
Address
The Helix
NDP
Government
EU
Disclaimer | Privacy