PHYSICAL AND BEHAVIORAL REQUIREMENTS AND WORKING CONDITIONS |
Activity | % of Time Performing Activity Never = 0%; Occasional = 1–33%; Frequent = 34–66%; Continuous = 67– 100% |
Physical and Behavioral Requirements |
Ability to be Customer-Service Oriented | Never Occasional Frequent Continuous |
Ability to Get Along with Others | Never Occasional Frequent Continuous |
Ability to be a Team Player | Never Occasional Frequent Continuous |
Ability to Manage Time Effectively | Never Occasional Frequent Continuous |
Ability to Prioritize Assignments | Never Occasional Frequent Continuous |
Ability to Solve Problems | Never Occasional Frequent Continuous |
Ability to be Multi-Task | Never Occasional Frequent Continuous |
Around Moving Machinery | Never Occasional Frequent Continuous |
| Never Occasional Frequent Continuous |
Carry/Lift Loads of: Light (up to 25 lbs.) Moderate (25-50 lbs.) Heavy (over 50 lbs.) |
Never Occasional Frequent Continuous Never Occasional Frequent Continuous Never Occasional Frequent Continuous |
Climb | Never Occasional Frequent Continuous |
Communicate Orally | Never Occasional Frequent Continuous |
Computer & Monitor Use | Never Occasional Frequent Continuous |
Crawl | Never Occasional Frequent Continuous |
Drives Motorized Vehicles | Never Occasional Frequent Continuous |
Handle Objects/Manual Dexterity | Never Occasional Frequent Continuous |
Hear | Never Occasional Frequent Continuous |
Keyboard Use | Never Occasional Frequent Continuous |
Operates Motorized Equipment | Never Occasional Frequent Continuous |
Perform Calculations | Never Occasional Frequent Continuous |
Push/Pull Loads of: Light (up to 25 lbs.) Moderate (25-50 lbs.) Heavy (over 50 lbs.) |
Never Occasional Frequent Continuous Never Occasional Frequent Continuous Never Occasional Frequent Continuous |
Reach above shoulder level | Never Occasional Frequent Continuous |
Read | Never Occasional Frequent Continuous |
Reason and Analyze | Never Occasional Frequent Continuous |
See | Never Occasional Frequent Continuous |
Sit | Never Occasional Frequent Continuous |
Squat | Never Occasional Frequent Continuous |
Stand | Never Occasional Frequent Continuous |
Travel | Never Occasional Frequent Continuous |
Twist | Never Occasional Frequent Continuous |
Walk | Never Occasional Frequent Continuous |
Write | Never Occasional Frequent Continuous |
Other ____________________________ | Never Occasional Frequent Continuous |
Other ____________________________ | Never Occasional Frequent Continuous |
Working Conditions |
Exposed to Blood Borne Pathogens | Never Occasional Frequent Continuous |
Exposed to Dust, Fumes and/or Gases | Never Occasional Frequent Continuous |
Exposed to Excessive Noise | Never Occasional Frequent Continuous |
Exposed to Heat and Cold | Never Occasional Frequent Continuous |
Exposed to Non-air Conditioned Environment | Never Occasional Frequent Continuous |
Exposed to Outside Weather Conditions | Never Occasional Frequent Continuous |
Office Environment | Never Occasional Frequent Continuous |
Other ____________________________ | Never Occasional Frequent Continuous |
Other ____________________________ | Never Occasional Frequent Continuous |