Campus Ergonomics Intake Form - Project

SUMMER SCHEDULE: Due to upcoming holiday schedules and resource availability, responses to this form will be delayed between July 7, 2025, and August 15, 2025.


If you meet the eligibility requirements, you may still submit a request. Responses will be provided after August 15, 2025


If you have immediate questions about ergonomics, email ergonomics@ucsf.edu, and we will do our best to assist you.


INSTRUCTIONS


This form is for UCSF Campus staff and faculty only.


Submit this form to request assistance with a design project related to new building design, existing building or space redesign, task design, or equipment/tool design. Underlined text are hyperlinks to other documents.


Before you PROCEED:


  • Confirm employment status is UCSF CAMPUS.
  • Review Which Ergonomics Program Should I Contact?
  • UCSF Health employees should not use this form. Contact UCSF Health Ergonomics instead.
  • If this project involves UCSF Campus and other types of employees or people, provide details in the form.
  • Identify the initial primary contact person.
  • This person may be a manager, supervisor, or someone who will coordinate on behalf of this project.
  • Have photos or files ready to submit, if these would be helpful.


Thank you for submitting this inquiry to the UCSF Ergonomics & Human Factors Program. We will contact you if we need more information and for the next steps.


If you need assistance with digital accessibility as you complete this form, let us know.

 

About the Requestor

This is the initial primary contact person who may be a manager, supervisor, or someone who will coordinate on behalf of this project. May be changed in the future

 
 
 
 

If no personal pronouns are provided, "they, them, theirs" will be used as default in communications

 
 
 
 
 
 
 

About the Project

 

Select all that apply

 

A brief name or street address to identify this project. This may be changed in the future.

 

Describe the overall scope of the project, including whether this is a large or small project and the type of workstations and work activities. You will also have the opportunity to submit photos or attachments with this request.

 
 
 
 
 
 
 

Actual or estimated number of people involved or impacted by this project

 
 
 

Provide any relevant dates, including whether this project is in the planning stages, or has any specific deadlines.

 
 
 
 
 
 

Attach any photos or files you think will be helpful for us to review to understand your needs with this project. You will have an opportunity to submit additional information later.

Drop your files here
 

Include who referred you to us, if available

 

Include any additional information you think will be helpful for us to know. You will have an opportunity to share more information later.