This position requires: | ||
Working in Office Environment | ______ No | __ X ___ Yes |
Working in Patient Care Unit (e.g. Nursing unit; outpatient clinic) | __ X ___ No | ______ Yes |
Exposure to human/animal blood, body fluids, or tissues | ______ No | __ X ___ Yes |
Exposure to harmful chemicals | ______ No | __ X ___ Yes |
Exposure to radiation | ______ No | __ X ___ Yes |
Exposure to animals | ______ No | __ X_ __ Yes |
Time Spent | |||
Never 0% | Occasionally 1-33% | Frequently 34-66% | Continuously 67-100% |
Standing | X | ||
Walking | X | ||
Sitting | X | ||
Reaching | X | ||
Lifting/Carrying | |||
Up to 10 lbs | X | ||
10lbs to 50 lbs | X | ||
More than 50 lbs | X | ||
Pushing/Pulling | |||
Up to 10 lbs | X | ||
10lbs to 50 lbs | X | ||
More than 50 lbs | X | ||
Use computer/keyboard | X |
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