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Sample Aircrew Risk Assessment

Select the Pilot in Command
Select the Co-pilot
Crew Rest
How many hours of uninterrupted sleep has each crew member had in the last 24 hours?
Pilot in Command
Co-pilot
Crew day
How many hours will you have been awake at your scheduled land time?
Pilot in Command
Co-pilot
Currency
How many days has it been since your last flight?
Pilot in Command
Co-pilot
Proficiency
How many flight hours has each crew member flown in the last 30 days?
Pilot in Command
Co-pilot
Person Stressors
On a scale of 1 to 10, where 1 is little to no personal stress and 10 is a very high level of stress, what is each crew member's current stress level?
Pilot in Command
1
2
3
4
5
6
7
8
9
10
Co-pilot
1
2
3
4
5
6
7
8
9
10
On a scale of 1 to 10, where 1 is not pressured at all and 10 is a strong sense of urgency, how much pressure does the crew feel about executing this flight?
1
2
3
4
5
6
7
8
9
10
What is the scheduled duration of your flight?
Environment and Equipment
On a scale of 1 to 5, where 1 is little to no effect and 5 is a serious negative effect, what impact do you think the following factors will make on your event/
Ceiling and/or visibility
1
2
3
4
5
6
7
8
9
10
Adverse wind/turbulence conditions
1
2
3
4
5
6
7
8
9
10
Icing
1
2
3
4
5
6
7
8
9
10
Airfield issues
1
2
3
4
5
6
7
8
9
10
Degraded aircraft equipment
1
2
3
4
5
6
7
8
9
10
Will this flight be conducted during daylight or at night?
Day
Day into night
Night
Night into day
Select all mission objectives you intend to attempt during this flight.
Fundamental Flight Maneuvers
Basic Instrument Maneuvers
Instrument Navigation
Instrument Approaches
Low Level Navigation
Emergency Procedure Training
Please indicate how likely you are encounter the following hazards in your flight:
Not at all likely
Possible, but highly unlikely
Possible
Somewhat likely
Very likely
Bird strike
Midair Collision
Inadvertent IMC
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