Staff Management > 07 Safety Management (44 docs)
Free Nursing and Assisted Living Facility Forms Policies for Residential Care, Nursing Homes, ALF, RCFE, CCL
Ergonomics Self Verification Form
Form used by an employee to assess their ability to lift.
In order for the facility to better assign lifting tasks to individuals who are able to perform the job, we require each employee to complete this form.
To Whom it May Concern,
I understand one lifting standard does not fit all persons, due to size, weight, height, and physical strength that it is my responsibility to ensure for my self-safety. I know I can safely lift:
||32 KB (33,386 bytes)
||April 27, 2004
||March 24, 2011
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