Safety-Report-Form-9

Fatigue Report Form

PURPOSE The form is used for fatigue analysis.

HOW TO COMPLETE THIS FORM
In sections 1 to 9, the reporting person must:
• Make sure that all subjects are clearly filled up and the applicable options encircled
• Submit it together with the Post-Flight Documents via File Upload
• The Safety Department will acknowledge and investigate this Fatigue Report
• Keep a copy for yourself.

(*) Indicates the field is required

2. When did it happen?

(e.g. DXB-BAH-LHR-DXB)

3. What happened?

1. Fully alert, wide awake
2. Very lively, somewhat responsive, but not at peak
3. OK, somewhat fresh
4. A little tired, less than fresh
5. Moderately tired, let down
6. Extremely tired, very difficult to concentrate
7. Completely exhausted

Alert Drowsy
0	1	2	3	4	5	6	7	8	9	10

Actions taken to manage or reduce fatigue (e.g. Cockpit nap):

Suggested Corrective Actions:

9. What happened? (check which is applicable)

(Check which is applicable)

Drop your file here or click here to upload You can upload up to 10 files.

Drop your file here or click here to upload You can upload up to 1 files.