Health and Safety (Display Screen Equipment) Regulations, 1992

Lancashire County Council

All printed versions are uncontrolled

HEALTH AND SAFETY (DISPLAY SCREEN EQUIPMENT) REGULATIONS, 1992

AS AMENDED BY THE HEALTH AND SAFETY (MISCELLANEOUS AMENDMENTS) REGULATIONS 2002

DSE CERTIFICATE OF RECOMMENDATION - OFFICE COPY

To be completed by the employee

Employee’s name:...... / Pay ref. no:

Directorate / DSO:…......

To be completed by the optician / GP

I confirm that I have tested the above employee’ s eye sight in accordance with the requirements of the Display Screen Equipment Regulations, 1992. In my opinion this employee requires: (Tick applicable box)

Requires Corrective Appliances (normally spectacles) either solely for use with VDU or containing a prescription specifically for VDU use (normally varifocals)
Please give reason for prescription specifically for VDU use :
Requires corrective appliances for general use including use with display screen equipment
Does not require corrective appliances for use with display screen equipment
Re test required in / months / years (Delete as applicable)

NOTE: You are reminded that the guidance to the Regulations states:- “Special corrective appliances (normally spectacles) provided to meet the requirements of the Regulations will be those appliances prescribed to correct vision defects at the viewing distance or distances used specifically for display screen work. . . . .experience has shown that. . . . . only a minority (less than 10%) will need corrective appliances for Display Screen Work.”

Signed:- ...... Date:......

(Optometrist/O.M.P.)

Please apply branch stamp:

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