Stanford University: Ergonomic Equipment Matching Fund

ANNOUNCEMENT: To help clarify and expedite the process, there have been several changes made to the Ergonomic Equipment Matching Fund. For details, click and read the Ergonomics Matching Fund webpage. These changes are immediately in effect starting December 15th, 2024.


The Ergonomic Equipment Matching Fund is a partnership program between Risk Management Services and Stanford Environmental, Health, & Safety Department to optimize ergonomics for computer workspaces. The program aims to encourage departments to support their employees’ ergonomic needs by offering a financial reimbursement for ergonomic equipment.


Intended for Stanford University faculty and staff who purchase EH&S-approved ergonomic equipment may be eligible for 50% matching funds reimbursement up to a maximum of $300 over the course of their employment. Ergonomic equipment must be on the pre-approved products list or recommended by the Stanford Ergonomics Program in a report/email. No other equipment will be accepted.



For requests to be processed all the necessary and accurate information must be submitted. If not, the request will be denied. The following will be needed to complete the form::

  • Submit iJournal transfer. Write down the iJournal number as it will be needed to complete the form. Please refer to the Fingate iJournal webpage for information on how to complete an iJournal
  • The employee’s job code which can be provided by their local HR representative.
  • Employee’s Certificate of EHS-3400 Computer Workstation Ergonomics training (from STARS)
  • PDF copy of the A) employee’s Self-Assessment Tool, B) Ergonomic Evaluation Report, OR C) Ergonomic Showroom Email
  • Copies of invoices/receipts for the equipment purchased


The Matching Fund Program is available for purchases made in the current fiscal year from Sept 1 - July 15 or until all established funds are depleted.


For current program details and FAQ, please visit the Ergonomics Matching Fund Webpage.

Reimbursement Information

Select
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Please ensure an iJournal is submitted before filling out this form. (ex. ij2009791)

Please enter the SUNet ID of the recipient employee (do not enter Stanford ID#)

Enter employee's job code (ex. 8591). Can be provide by Local Human Resource representative.

Phone
Phone

Equipment For Reimbursement Request

Equipment must be from the EH&S pre-approved computer ergonomics product list. Enter brand and model of each item and the cost. Receipts, POs, and/or Invoices must be submitted and attached to the iJournal reimbursement request and to this form in order to be processed. Reimbursement requests that are incomplete may be denied and/or may delay processing.

Select
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Computer Workstation Training date must be within the last 2 years. Employee may find this information in STARS Training History. (Note: date entered must match training record for reimbursement request to be approved).

Laboratory Ergonomics Training date must be within the last 2 years. Employee may find this information in STARS Training History. (Note: date entered must match training record for reimbursement request to be approved).

Select or enter value
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Brand and Model Name, Equipment Type (i.e. Logitech M510 mouse)

Enter the PO, Invoice #, Order #, Requisition #, P-Card Transaction number, or the Date of Receipt as applicable

Total cost of equipment as shown as PO, invoice or receipt


Brand and Model Name, Equipment Type (i.e. Logitech M510 mouse)

Enter the PO, Invoice #, Order #, Requisition #, P-Card Transaction number, or the Date of Receipt as applicable

Total cost of equipment as shown as PO, invoice or receipt


Brand and Model Name, Equipment Type (i.e. Logitech M510 mouse)

Enter the PO, Invoice #, Order #, Requisition #, P-Card Transaction number, or the Date of Receipt as applicable

Total cost of equipment as shown as PO, invoice or receipt


Brand and Model Name, Equipment Type (i.e. Logitech M510 mouse)

Enter the PO, Invoice #, Order #, Requisition #, P-Card Transaction number, or the Date of Receipt as applicable

Total cost of equipment as shown as PO, invoice or receipt


Brand and Model Name, Equipment Type (i.e. Logitech M510 mouse)

Enter the PO, Invoice #, Order #, Requisition #, P-Card Transaction number, or the Date of Receipt as applicable

Total cost of equipment as shown as PO, invoice or receipt


List the following information for all additional items including the brand, model, item type; order information, and total cost for each item


Total cost must match total cost shown on PO, invoice, order, requisition, and/or receipts

=50% of Total Cost, not to exceed $300. (i.e. if total cost of equipment is $500, max reimbursement is 50%, or $250; if total cost of equipment is $800, max reimbursement is $300).


Phone

Upload supporting documents to this form: 1 - computer ergonomics self-assessment form -OR- the EH&S ergonomics evaluation report performed by the ergonomics specialist 2 - a copy of PO, receipt or invoice for each item as proof of purchase Note: these items must match the iJournal transfer request in order to be processed.

Drag and drop files here or