Health and Safety

DSE Checklist

(Scroll down to commence checklist)


This checklist is a self-assessment questionnaire to be completed by DSE 'users' (staff or research student) for their main workstation. DSE assessors may also use it for reviewing a user’s workstation.

The checklist aims to highlight any problems with a user’s workstation equipment and/or its set-up or with the work routine. It is a requirement of University policy that there is a record of an assessment for each DSE user and therefore it must be completed when requested by the user’s School/Department.

The DSE assessor should check through the form and arrange to see the user if issues have been identified; any actions or recommendations will be recorded. Typically the content of the form should be reviewed by the user every 2 years (the local DSE assessor will prompt this to take place).

Data Protection Statement

Personal data will be processed in accordance with the provisions of current UK data protection legislation. Completed DSE Checklists will be kept securely by the University Safety Office for up to 6 months after receipt.

Appointed DSE Assessors are informed to keep any DSE User's completed  Checklist submitted to them, securely and not to share the data with anyone else without the permission of the DSE User.

It is sometimes necessary for the University to permit the University’s appointed Occupational Health Provider to view an individual’s DSE Checklist for health assessment purposes in connection with the individual’s work activity.

  • Instructions
    Complete all fields in the form. The majority of the questions are yes or no answers, please select your answer as appropriate and if selecting 'no', please hover over the question, and attempt to take action by noting the advice given. All questions marked with * are mandatory fields and must be completed in order to submit this form. Any guidance marked with black asterisks relate to the definitions given in the right hand column of this page. To add notes regarding the various questions, please use the large text box at the end of each section. Upon completion, press Submit on the final page of the form. It will be emailed to the email address entered in the ‘DSE User email’ field and the user should then forward this to their DSE assessor for review.
  • Name of 'user'
  • Do you work full-time?
  • Do you routinely carry out University-related DSE work/study at home or in another location off-site?
  • For your DSE work, which of the following do you use:

Related Links:

Definitions (referenced in self-assessment questionnaire):

*DSE Assessor:

Means the local Display Screen Equipment Assessor(s) who should be named in the School/Dept Safety Policy. If there is no such person in post, refer to the Safety Office.

**Workstation Accessories:

A range of workstation accessories such as wrist rests, document holders, footrests, etc. is available through the University's preferred stationery supplier; order through School Office or local manager.


A range of furniture (desks and chairs) is available through the University's preferred furniture supplier. Users should refer to the suppliers via the DSE Assessor, School/Departmental Safety Officer or School Office. 


Health and Safety Department

Pharmacy Building (Building 63)
University Park
University of Nottingham
Nottingham, NG7 2RD

Telephone: Telephone: +44 (0)115 9513401
Email: h&