COPA Flight Risk Assessment Tool

• Route of Flight

• Prepared by

• Conducted on

  Date

• Document No.

General Flight Experience

• Have you completed a Flight Experience worksheet in the past 90 days?

  YES

  NO

• Years actively Flying?

  Less than 2

  2-5 Years

  5-10 Years

  More than 10 Years

• Certificate Held

  ATP or CFI

  Commercial with Instrument Rating

  Private with Instrument Rating

  Private VFR Only

  Student Pilot

• Time in Type

  Greater than 200 Hours

  150-200 Hours

  100-149 Hours

  50-99 Hours

  Less than 50 Hours

• Cirrus Time in last 90 Days

  More than 35 Hours

  25-34

  10-24

  5-9 Hours

  Less than 5

• Cirrus Landings in the last 90 Days

  More than 10

  6-9

  3-5

  1-2

  0

• Enter your Flight Proficiency Category (1 equals lowest proficiency, 3 equals highest proficiency)

  Category 1

  Category 2

  Category 3

• Accident or incident on preceding 90 Days?

  YES

  NO

Instrument Flight Experience

• I have completed an instrument proficiency assessment within 90 days?

  YES

  NO

• Enter your Instrument Proficiency Category (1 equals lowest proficiency, 3 equals highest proficiency)

  Category 1

  Category 2

  Category 3

• Years Flying IFR

  More than 5

  1-5 Years

  Less than 1 year

• Hours Flown IFR in previous 90 Days

  More than 35 Hours

  25-34

  10-24

  5-9 Hours

  Less than 5

• Simulated or Actual Instrument hours in Last 90 days

  greater than 3 Hours

  1-3 Hours

  Less than 1 Hour

• Hand Flown Approaches within previous 90 Days

  More than 2

  1-2

  0

• Coupled Approaches in the previous 90 Days

  More than 4

  1-4

  0

General Flight informattion

• Flight Rules for this Flight

  VFR

  IFR

• View Flight Planning Websites?

  YES

  NO

• COPA weather planning resource
  http://www.cirruspilots.org/Weather/Outlook.aspx

• Weather.gov
  http://aviationweather.gov/adds/

• Graphical Weather Forecast
  http://weather.rap.ucar.edu/model/

• Ceiling Forecast - This opens a webpage that can provide graphical depictions of forecast ceilings. Select "open link" and select "Ceiling/Sky Cover" from the list. The drop down menu offers several options. Consider looking at the "Ceiling Height (Cat)" option and examine the graphics for your proposed time and date
  http://www.nws.noaa.gov/mdl/forecast/graphics/MAV/

• Click link to look at forecast winds, precipitation and clouds
  http://www.usairnet.com/cgi-bin/launch/code.cgi

• NOTAM Retrieval page
  https://pilotweb.nas.faa.gov/PilotWeb/

• Area forecast Discussion-
  Note: advanced content
  http://www.wrh.noaa.gov/zoa/cwa.php

• Link to SkewT/Log P web page
  http://rucsoundings.noaa.gov/gifs/

Pilot Factors

• Pilot is Proficient for expected weather

  YES

  NO

• Describe mitigation plan

• Pilot fitness for flight

  pilot has no IMSAFE issues

  pilot has minor IMSAFE condition

  pilot not fit for PIC Duty

• Duty Hours

  Duty time of more than 14 hours

  Duty Time 8-14 hours

  Duty Time less than 8 Hours

Aircraft Factors

• Aircraft is equipped and appropriate for conditions likely to be encountered. Including Density Altitude, Icing and runway lengths

  YES

  NO

• Aircraft is in good shape with no airworthiness issues?

  YES

  NO

EnVironment

• Is the flight during the day?

  YES

  NO

• Ceilings at departure airport

  Ceilings below landing minimums

  Ceilings 200'-500'

  Ceilings 500'-1000'

  Ceilings 1000'-2000' AGL

  VFR CONDITIONS

• Forecast Ceilings at Destination

  Ceilings below landing minimums

  Ceilings 200'-500'

  Ceilings 500'-1000'

  Ceilings 1000'-2000' AGL

  VFR CONDITIONS

• Complexity of flight plan and Airspace. (Use Slider to Estimate impact on flight risk)

• Terrain complexity, unfamiliar terrain concerns or Density altitude factor

• Departure or arrival runway length issues

• Potential Crosswind component

• Convective activity on route

  YES

  NO

• Do you have onboard weather?

  YES

  NO

• Consider NO GO

• Degree to which deviations are likely to be required

• Is Icing in the Forecast?

  YES

  NO

• Is airplane FIKI equipped and are you trained to use it?

  YES

  NO

• CONSIDER NO GO

External Pressures

• Importance of mission

  Must be completed as planned

  Some Flexibility

  Schedule can be changed

• Nervous or distracting passenger

  No

  Yes

• Self imposed pressure

  No

  Yes

Additional Factors and Risk Mitigation Strategies

• Other risk factor

Additional Factor

• Additional risk

• Impact on Safety

• Mitigation Possible

  YES

  NO

• Explain Mitigation for this risk

• Plan to take an instructor or experienced pilot.