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Hitachi Vantara Personal Ergonomic Evaluation Order Form

Hitachi Vantara has partnered with ERGOhealthy to provide individual ergonomic evaluations to our employees.  If you are experiencing specific workstation discomfort, you may order a one-on-one evaluation with an ERGOhealthy Coach who will work with you in English via phone and internet.  

Your cost center will be charged US$295.  Upon submitting your order, you will be contacted by ERGOhealthy and asked to complete an on-line questionnaire (15 minutes).  You will then be contacted by your coach to set up a confidential evaluation call.  Your coach will support you for six months, as needed, and a personal evaluation report will be provided to you with suggestions to improve your workstation positioning and comfort.

Your manager will be notified that you have submitted an ergo evaluation Order Form.  They will not receive your evaluation data, though if any equipment ordering is recommended you will be asked to share the “equipment recommendation checklist” page to support that expense.

Full Name

Link to Hitachi Vantara intranet Employee Directory to check your department cost center (to access this link, you must be logged in to the Hitachi Vantara intranet network):

Your Manager's Name

Where is your main work location?