Virtual Assessment Request Form

Adapted assessment delivered through video technologies during the Covid-19 lockdown

If you have booked a Virtual Assessment and would now like to arrange for the virtual assessment to be carried our for yourself, or other member of staff *, please complete the form below and we will be in touch to schedule a suitable appointment time.

* IMPORTANT NOTICEBy completing this form you confirm that you have consent to share any 3rd 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.
Please enter details of the authorised person(s) for secure receipt of personal information
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
This is optional. Leave blank if not required.
To be Assessed
Details about the person to be assessed and their location

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

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DSE Needs Assessor
Thank you very much for providing the student with such a beneficial assessment and for sending over the report and quotations. Our client has also provided me with further feedback to say the assessment was a very positive experience for her which is lovely to hear. It is also clear that you have provided the most suitable equipment for her which is excellent as during my assessment she was unsure she would ever find a chair comfortable enough to sit in for any length of time. Thanks again and I look forward to working with you and Healthy Workstations in the future!
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