UCSF Standard Task Chair Program Request Form

UCSF Standard Task Chair Program Request Form

Eligibility

This program is for UCSF CAMPUS staff and faculty only.

BEFORE YOU PROCEED: Campus staff and faculty (including physicians who work within UCSF Health facilities) must verify they receive a paycheck from the Business Unit: UCSF Campus.

How to confirm your employment status:

Click this link to view your paycheck: UCPath
Reference your paycheck for a quick verification
For Campus staff and faculty, your Business Unit will be UCSF Campus
If your Business Unit is NOT UCSF Campus:
Review Which Ergonomics Program Should I Contact?
This includes UCSF Health employees who need to contact UCSF Health Ergonomics

About the program

One Workplace (OWP) offers a chair fitting program by appointment.

This program is offered by One Workplace (OWP) to provide UCSF CAMPUS staff and faculty the ability to try out different standard chairs before purchases are made by their departments.

During each session, an OWP representative will help UCSF CAMPUS staff and faculty select a UCSF standard chair that meets your needs.

All UCSF standard chairs meet ergonomics, safety, and sustainability requirements and are designed to meet the sitting needs of 90 percent of people.

Typical appointments will be at Mission Bay on select Thursdays from 11:00 am – 1:00 pm. An OWP representative will contact you regarding scheduling.

OWP also has a demo program for approved task chairs and stools. Contact UCSFSupportTeam@OneWorkplace.com for more information.

Purpose

This program allows UCSF Campus staff and faculty to:

Test UCSF standard task chairs
Receive basic information about seating to help you decide what to purchase
This program does not address in-depth questions or needs related to seating that may be referred to the UCSF Ergonomics & Human Factors Program
To address other issues related to ergonomics, review these pathways and follow the instructions for the next steps: Pathways for Ergonomics Assistance

Prerequisites

UCSF Campus staff or faculty
Have supervisor permission (your department purchases all equipment)
Submit photos of current seating

Next steps

Once your request has been reviewed, you will receive an email regarding the next steps. Incomplete forms will be placed on hold and may need to be resubmitted. When indicated, some fittings may be referred to another team.

Questions

If you would like to ask questions about this program prior to submitting a request, contact One Workplace.

Are you Campus staff or faculty?*

I have referenced my Paycheck and confirmed that my Business Unit is listed as UCSF Campus.

How to check this:

Take a moment to reference your paycheck for a quick verification.
Your paycheck lists your Business Unit in the upper-right corner.
For Campus staff and faculty, your Business Unit will be "UCSF Campus"

Click this link to view your paycheck: UCPath

Select or enter value

Instructions for Non-UCSF Campus staff and faculty

Do not submit this form. Instead, identify which program you need to contact.

Within the UCSF community, there are multiple ergonomics programs that support different people.

Review: Which Ergonomics Program Should I Contact? to find the program assigned to support you.

Separate ergonomics programs are available for:

UCSF Campus students
UCSF employees at:
UCSF Health (MedCtrErgo@ucsf.edu)
UCSF Benioff Children's Hospital Oakland (BCHO)
UCSF St. Mary's
UCSF Saint Francis
UCSF affiliates
Employees and contractors employed by non-UCSF organizations

First Name*

Last Name*

Lived name

Email*

Confirm Email*

Contact phone number *

Phone

Department *

Supervisor/manager first name*

Supervisor/manager last name*

Supervisor/manager email address*

Height*

Example: 5 feet, 7 inches

Employee Weight*

All seating options have a weight capacity. Newer chairs rate at 300 pounds (lbs). Older chairs may rate at 225 lbs. Safety issues may occur if your chair is rated at the wrong capacity for you.

Under 225 lbs.

Between 225 - 300 lbs.

Between 300 - 400 lbs.

Above 400 lbs.

Why do need you a new chair?*

Click all that apply.

Select or enter value

Comments about current seating or seating needs*

Photos of Current Seating*

Showing us your current seating helps us provide guidance to you.

Submit the following:

a) A photo of YOUR CHAIR without you in it.

AND

b) A photo of YOU SITTING IN YOUR CHAIR shown from the side. Remove any jackets from the chair backrest so the side of the chair is visible.

AND

c) A photo of the chair label (typically found under the seat pan).

Drag and drop files here or

Send me a copy of my responses

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