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

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.

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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