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    • Institute of Epidermal Cell Therapy's Job Position Physical Requirements Policy Checklist

    Physical Requirements

    Sitting
    Teaching, performing services     		Is the employee required to sit for extended periods of time without being able to leave the work area? Yes
    Standing
    Teaching, performing services    		 Is the employee required to remain on his or her feet in an upright position for continuous periods of time without being able to leave the work area? Yes
    Climbing
    Stock supplies    		 Is the employee required to climb ladders or scaffolding? To climb and work in overhead areas, as when repairing warehouse fans? No
    Walking
    Check student/staff performance    		 Is the employee required to walk considerable distances in the facility during the course of his or her work? (Excludes walking to and from work area, cafeteria, etc.) No
    Lifting
    Stock Supplies    		 Is the employee required to raise or lower objects from one level to another regularly during the shift? No
    Pulling and/or Pushing
    		 Does the job require exerting force up to ___ pounds on a regular basis so that the object is moved to or away from the employee? N/A
    Carrying
    Stock Supplies    		 Is the employee required, on a regular basis, to carry objects in his or her arms or on the shoulder(s)? Yes
    Grasping
    Teaching, performing services    		 Does the job require that the employee regularly pick up objects with fingers? Yes
    Reaching
    Teaching, performing services    		 Is the employee regularly required to use the hands and arms to reach for objects? Yes
    Stooping and Crouching
    Teaching, performing services    		 Is the employee regularly required to bend forward by bending at the waist or by bending legs and spine? Yes
    Crawling
    		 Is the employee required to work in a confined space? To crawl and move about on his or her hands and knees? No
    Color Determination
    Equipment Use    		 Does the job require color determination vision (no color blindness)? Yes
    Near Acuity
    		 Does the job require clarity of vision at 20 feet or more, with or without corrective lenses? N/A
    Speaking
    Communicating instructions    		 Does the job require expressing ideas by the spoken word? Yes
    Listening
    Communicating instructions    		 Does the job require the perception of speech or the nature of sounds in the air? Yes
    Tasting or Smelling
    Performing Services    		 Does the job require the ability to distinguish differences in quality of flavors and/or odors, using the tongue and/or nose? Yes

    Mental Requirements

    General Intelligence
    		 Does the employee have the ability to learn and comprehend basic instructions and orientation to the job? Yes
    Motor Coordination Skills
    		 Is the employee able to coordinate eyes, hands, and fingers rapidly and accurately and handle precise movements? Yes
    Coordination of Eyes, Hands, and Feet
    		 Does the employee have the ability to coordinate the eyes, hands, and feet with each other in response to visual stimuli? Yes
    Verbal Intelligence
    		 Does the employee have the ability to understand the meanings of words and respond effectively? Yes
    Numerical Intelligence
    		 Does the employee have the ability to perform basic arithmetic accurately and quickly? Yes

    Workplace Environmental Conditions

    Noise Conditions
    		 Is the employee exposed during a shift to constant or intermittent sounds at a level sufficient to cause hearing loss or fatigue? No
    Heat
    		 Is the employee subject to high temperatures that result in significant body discomfort? No
    Cold
    		 Is the employee exposed to low temperatures that result in significant body discomfort? No
    Injury Exposures
    		 Is the employee exposed to workplace hazards more frequently than normal? To potential injuries? No
    Atmospheric Exposures
    		 Is the employee exposed to dusts, fumes, vapors, or mists that could affect the health of the employee? No

    Employee Acknowledgement

    I have read and I understand Institute of Epidermal Cell Therapy's Job position Physical Requirements Policy.

    Employee's Printed Name: ____________________
    Employee's Signature: _______________________
    Position: ___________________
    Date: ___________________

    Physical Requirements
    IECT Physical Requirements Checklist - PDF
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