Assessment Request Form

Our Assessment Services

Because everyone is unique there is no 'one-size' solution!

That is why we enjoy speaking directly with end users to ensure that organisations are investing in the right equipment! We are very experienced and approachable, so please consult us for advice..

If you would like to arrange an on-site assessment for yourself, or other member of staff *, please complete the form below and we will be in touch to confirm a suitable appointment.

*IMPORTANT NOTICE: By completing this form you confirm that you have consent to share any 3^rd party personal information under the latest Data Protection regulations. HWS undertake to protect your details in line with our Privacy Policy. If you wish to share health or other detailed information, please send separately in a password protected file. Thank You.

Requester's details

Please enter details for the person making the request - i.e. you.

Full Name *

Organisation Name *

Telephone Number *

Email Address *

Confirm Email Address *

Job Title *

Manager or Budget Holder *

Yes No

Please enter details of the authorised person(s) for secure receipt of personal information

Send assessment report to

Email Address

Telephone Number

For regular account holders, this may have been pre-agreed.

We can supply a copy of the assessment to a second authorised person - e.g. HR Dept., H&S

Copy report to

Email Address

This is optional. Leave blank if not required.

To be Assessed

Details about the person to be assessed and their location

Full Name *

Location (address)

Postcode

Telephone Number

Email Address

Job Title

Appointment Booking

Parking Available *

Yes No

Car parking booking required

Yes No

Additional Information with regard to availability or scope of the assessment

All information submitted is processed in accordance with our Privacy Policy.

Sheree Lewis-Jones, Manager

Staff member who came to do my assessment was very empathetic to my situation, they were very knowledgeable in trying a new chair and amending my current chair. Excellent communication from the main office about appointment and delivery etc. Highly recommend.

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Healthy Workstations