{"id":55,"date":"2019-03-07T14:56:12","date_gmt":"2019-03-07T19:56:12","guid":{"rendered":"https:\/\/sites.temple.edu\/ehrsforms\/?page_id=55"},"modified":"2019-03-07T15:24:02","modified_gmt":"2019-03-07T20:24:02","slug":"post-ergonomic-assessment-questionnaire","status":"publish","type":"page","link":"https:\/\/sites.temple.edu\/ehrsforms\/post-ergonomic-assessment-questionnaire\/","title":{"rendered":"Post-Ergonomic Assessment Questionnaire"},"content":{"rendered":"\n<p class=\"has-large-font-size\"><strong>Post-Ergonomic Assessment Questionnaire <\/strong><\/p>\n\n\n\n<p><\/p>\n\n\n\n<script>\nvar gform;gform||(document.addEventListener(\"gform_main_scripts_loaded\",function(){gform.scriptsLoaded=!0}),document.addEventListener(\"gform\/theme\/scripts_loaded\",function(){gform.themeScriptsLoaded=!0}),window.addEventListener(\"DOMContentLoaded\",function(){gform.domLoaded=!0}),gform={domLoaded:!1,scriptsLoaded:!1,themeScriptsLoaded:!1,isFormEditor:()=>\"function\"==typeof 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gform.doHook(\"filter\",o,arguments)},removeAction:function(o,r){gform.removeHook(\"action\",o,r)},removeFilter:function(o,r,e){gform.removeHook(\"filter\",o,r,e)},addHook:function(o,r,e,t,n){null==gform.hooks[o][r]&&(gform.hooks[o][r]=[]);var d=gform.hooks[o][r];null==n&&(n=r+\"_\"+d.length),gform.hooks[o][r].push({tag:n,callable:e,priority:t=null==t?10:t})},doHook:function(r,o,e){var t;if(e=Array.prototype.slice.call(e,1),null!=gform.hooks[r][o]&&((o=gform.hooks[r][o]).sort(function(o,r){return o.priority-r.priority}),o.forEach(function(o){\"function\"!=typeof(t=o.callable)&&(t=window[t]),\"action\"==r?t.apply(null,e):e[0]=t.apply(null,e)})),\"filter\"==r)return e[0]},removeHook:function(o,r,t,n){var e;null!=gform.hooks[o][r]&&(e=(e=gform.hooks[o][r]).filter(function(o,r,e){return!!(null!=n&&n!=o.tag||null!=t&&t!=o.priority)}),gform.hooks[o][r]=e)}});\n<\/script>\n\n                <div class='gf_browser_gecko gform_wrapper gform_legacy_markup_wrapper gform-theme--no-framework' data-form-theme='legacy' data-form-index='0' id='gform_wrapper_10' ><form method='post' enctype='multipart\/form-data'  id='gform_10'  action='\/ehrsforms\/wp-json\/wp\/v2\/pages\/55' data-formid='10' novalidate>\n                        <div class='gform-body gform_body'><ul id='gform_fields_10' class='gform_fields top_label form_sublabel_below description_below validation_below'><li id=\"field_10_1\" class=\"gfield gfield--type-name gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label gfield_label_before_complex' >Name<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_complex ginput_container ginput_container--name no_prefix has_first_name no_middle_name has_last_name no_suffix gf_name_has_2 ginput_container_name gform-grid-row' id='input_10_1'>\n                            \n                            <span id='input_10_1_3_container' class='name_first gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_1.3' id='input_10_1_3' value=''   aria-required='true'     \/>\n                                                    <label for='input_10_1_3' class='gform-field-label gform-field-label--type-sub '>First<\/label>\n                                                <\/span>\n                            \n                            <span id='input_10_1_6_container' class='name_last gform-grid-col gform-grid-col--size-auto' >\n                                                    <input type='text' name='input_1.6' id='input_10_1_6' value=''   aria-required='true'     \/>\n                                                    <label for='input_10_1_6' class='gform-field-label gform-field-label--type-sub '>Last<\/label>\n                                                <\/span>\n                            \n                        <\/div><\/li><li id=\"field_10_2\" class=\"gfield gfield--type-date gfield--input-type-datepicker gfield--datepicker-no-icon gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_10_2'>Original Assessment Date<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_date'>\n                            <input name='input_2' id='input_10_2' type='text' value='' class='datepicker gform-datepicker mdy datepicker_no_icon gdatepicker-no-icon'   placeholder='mm\/dd\/yyyy' aria-describedby=\"input_10_2_date_format\" aria-invalid=\"false\" aria-required=\"true\"\/>\n                            <span id='input_10_2_date_format' class='screen-reader-text'>MM slash DD slash YYYY<\/span>\n                        <\/div>\n                        <input type='hidden' id='gforms_calendar_icon_input_10_2' class='gform_hidden' value='https:\/\/sites.temple.edu\/ehrsforms\/wp-content\/plugins\/gravityforms\/images\/datepicker\/datepicker.svg'\/><\/li><li id=\"field_10_3\" class=\"gfield gfield--type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_10_3'>Building<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_3' id='input_10_3' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_10_4\" class=\"gfield gfield--type-text gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_10_4'>Room<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_text'><input name='input_4' id='input_10_4' type='text' value='' class='medium'     aria-required=\"true\" aria-invalid=\"false\"   \/><\/div><\/li><li id=\"field_10_5\" class=\"gfield gfield--type-section gsection field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><h2 class=\"gsection_title\">Assessment Feedback<\/h2><\/li><li id=\"field_10_6\" class=\"gfield gfield--type-radio gfield--type-choice gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' >The adjustments made to my workstation have been beneficial.<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_10_6'>\n\t\t\t<li class='gchoice gchoice_10_6_0'>\n\t\t\t\t<input name='input_6' type='radio' value='Strongly Agree (5)'  id='choice_10_6_0'    \/>\n\t\t\t\t<label for='choice_10_6_0' id='label_10_6_0' class='gform-field-label gform-field-label--type-inline'>Strongly Agree (5)<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_10_6_1'>\n\t\t\t\t<input name='input_6' type='radio' value='Agree (4)'  id='choice_10_6_1'    \/>\n\t\t\t\t<label for='choice_10_6_1' id='label_10_6_1' class='gform-field-label gform-field-label--type-inline'>Agree (4)<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_10_6_2'>\n\t\t\t\t<input name='input_6' type='radio' value='Neutral (3)'  id='choice_10_6_2'    \/>\n\t\t\t\t<label for='choice_10_6_2' id='label_10_6_2' class='gform-field-label gform-field-label--type-inline'>Neutral (3)<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_10_6_3'>\n\t\t\t\t<input name='input_6' type='radio' value='Disagree (2)'  id='choice_10_6_3'    \/>\n\t\t\t\t<label for='choice_10_6_3' id='label_10_6_3' class='gform-field-label gform-field-label--type-inline'>Disagree (2)<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_10_6_4'>\n\t\t\t\t<input name='input_6' type='radio' value='Strongly Disagree (1)'  id='choice_10_6_4'    \/>\n\t\t\t\t<label for='choice_10_6_4' id='label_10_6_4' class='gform-field-label gform-field-label--type-inline'>Strongly Disagree (1)<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_10_6_5'>\n\t\t\t\t<input name='input_6' type='radio' value='Not Applicable (0)'  id='choice_10_6_5'    \/>\n\t\t\t\t<label for='choice_10_6_5' id='label_10_6_5' class='gform-field-label gform-field-label--type-inline'>Not Applicable (0)<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_10_8\" class=\"gfield gfield--type-radio gfield--type-choice gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' >The training I received during my workstation assessment made sense, and I am able to utilize it myself.<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_10_8'>\n\t\t\t<li class='gchoice gchoice_10_8_0'>\n\t\t\t\t<input name='input_8' type='radio' value='Strongly Agree (5)'  id='choice_10_8_0'    \/>\n\t\t\t\t<label for='choice_10_8_0' id='label_10_8_0' class='gform-field-label gform-field-label--type-inline'>Strongly Agree (5)<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_10_8_1'>\n\t\t\t\t<input name='input_8' type='radio' value='Agree (4)'  id='choice_10_8_1'    \/>\n\t\t\t\t<label for='choice_10_8_1' id='label_10_8_1' class='gform-field-label gform-field-label--type-inline'>Agree (4)<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_10_8_2'>\n\t\t\t\t<input name='input_8' type='radio' value='Neutral (3)'  id='choice_10_8_2'    \/>\n\t\t\t\t<label for='choice_10_8_2' id='label_10_8_2' class='gform-field-label gform-field-label--type-inline'>Neutral (3)<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_10_8_3'>\n\t\t\t\t<input name='input_8' type='radio' value='Disagree (2)'  id='choice_10_8_3'    \/>\n\t\t\t\t<label for='choice_10_8_3' id='label_10_8_3' class='gform-field-label gform-field-label--type-inline'>Disagree (2)<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_10_8_4'>\n\t\t\t\t<input name='input_8' type='radio' value='Strongly Disagree (1)'  id='choice_10_8_4'    \/>\n\t\t\t\t<label for='choice_10_8_4' id='label_10_8_4' class='gform-field-label gform-field-label--type-inline'>Strongly Disagree (1)<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_10_8_5'>\n\t\t\t\t<input name='input_8' type='radio' value='Not Applicable (0)'  id='choice_10_8_5'    \/>\n\t\t\t\t<label for='choice_10_8_5' id='label_10_8_5' class='gform-field-label gform-field-label--type-inline'>Not Applicable (0)<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_10_9\" class=\"gfield gfield--type-radio gfield--type-choice gfield_contains_required field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' >Since my ergonomic assessment, I feel more comfortable at my workstation.<span class=\"gfield_required\"><span class=\"gfield_required gfield_required_asterisk\">*<\/span><\/span><\/label><div class='ginput_container ginput_container_radio'><ul class='gfield_radio' id='input_10_9'>\n\t\t\t<li class='gchoice gchoice_10_9_0'>\n\t\t\t\t<input name='input_9' type='radio' value='Strongly Agree (5)'  id='choice_10_9_0'    \/>\n\t\t\t\t<label for='choice_10_9_0' id='label_10_9_0' class='gform-field-label gform-field-label--type-inline'>Strongly Agree (5)<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_10_9_1'>\n\t\t\t\t<input name='input_9' type='radio' value='Agree (4)'  id='choice_10_9_1'    \/>\n\t\t\t\t<label for='choice_10_9_1' id='label_10_9_1' class='gform-field-label gform-field-label--type-inline'>Agree (4)<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_10_9_2'>\n\t\t\t\t<input name='input_9' type='radio' value='Neutral (3)'  id='choice_10_9_2'    \/>\n\t\t\t\t<label for='choice_10_9_2' id='label_10_9_2' class='gform-field-label gform-field-label--type-inline'>Neutral (3)<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_10_9_3'>\n\t\t\t\t<input name='input_9' type='radio' value='Disagree (2)'  id='choice_10_9_3'    \/>\n\t\t\t\t<label for='choice_10_9_3' id='label_10_9_3' class='gform-field-label gform-field-label--type-inline'>Disagree (2)<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_10_9_4'>\n\t\t\t\t<input name='input_9' type='radio' value='Strongly Disagree (1)'  id='choice_10_9_4'    \/>\n\t\t\t\t<label for='choice_10_9_4' id='label_10_9_4' class='gform-field-label gform-field-label--type-inline'>Strongly Disagree (1)<\/label>\n\t\t\t<\/li>\n\t\t\t<li class='gchoice gchoice_10_9_5'>\n\t\t\t\t<input name='input_9' type='radio' value='Not Applicable (0)'  id='choice_10_9_5'    \/>\n\t\t\t\t<label for='choice_10_9_5' id='label_10_9_5' class='gform-field-label gform-field-label--type-inline'>Not Applicable (0)<\/label>\n\t\t\t<\/li><\/ul><\/div><\/li><li id=\"field_10_10\" class=\"gfield gfield--type-textarea field_sublabel_below gfield--no-description field_description_below field_validation_below gfield_visibility_visible\"  ><label class='gfield_label gform-field-label' for='input_10_10'>Comments<\/label><div class='ginput_container ginput_container_textarea'><textarea name='input_10' id='input_10_10' 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