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PERSONAL FACTORS. Greater than 500. How many hours in crew position?. 200 - 500. Less than 200. 0. 1. 2. How many days since last flight?. Less than 10. 10 -20. Greater than 20. 0. 1 - 2. 3 - 4. Is your spouse pregnant or does a family member have medical problems?. No. Yes.
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PERSONAL FACTORS Greater than 500 How many hours in crew position? 200 - 500 Less than 200 0 1 2 How many days since last flight? Less than 10 10 -20 Greater than 20 0 1 - 2 3 - 4 Is your spouse pregnant or does a family member have medical problems? No Yes With complications 0 0-2 3-4 Having marital problems? No Some Yes 0 1 - 2 3 - 4 No Some Yes Are you having financial problems? 0 1 3 Low Medium High What is your level of job stress? 0 1 - 2 3 - 4 Your physical/mental condition? Excellent Fair Poor 0 1 - 2 2 - 3 Instructions: Honestly answer the questions. Total the points and compare your total with the risk categories. Inform the other crew members during the crew briefing of your personal risk category.
MISSION FACTORS Less than 5 Hrs 5 - 8 Hrs Greater than 8 Hrs Sortie Duration 0 1 2 Is this a night sortie? No Yes 0 1 No Yes Is this an NVG sortie? 0 2 Your assessment of mission complexity. Simple Routine Complex 0 1 - 2 3 - 4 0400-0659 1501-2059 Show time? 0600-1500 2100-0359 0 1-2 3-4 Broken Sleep Yes No Did you get adequate sleep prior to crew show? 0 1-2 3-4 0 -12 POINTS………………………LOW 13 - 22 POINTS……………………CAUTION 23 & ABOVE POINTS…………….HIGH Instructions: Honestly answer the questions. Total the points and compare your total with the risk categories. Inform the other crew members during the crew briefing of your personal risk category.