Information

  • Route of Flight

  • Prepared by

  • Conducted on

  • Document No.

Personal Minimums worksheet

General Flight Experience

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

  • Years actively Flying?

  • Certificate Held

  • Time in Type

  • Cirrus Time in last 90 Days

  • Cirrus Landings in the last 90 Days

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

  • Accident or incident on preceding 90 Days?

Instrument Flight Experience

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

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

  • Years Flying IFR

  • Hours Flown IFR in previous 90 Days

  • Simulated or Actual Instrument hours in Last 90 days

  • Hand Flown Approaches within previous 90 Days

  • Coupled Approaches in the previous 90 Days

Proposed flight

General Flight informattion

  • Flight Rules for this Flight

  • View Flight Planning Websites?

  • 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

  • Describe mitigation plan

  • Pilot fitness for flight

  • Duty Hours

Aircraft Factors

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

  • Aircraft is in good shape with no airworthiness issues?

EnVironment

  • Is the flight during the day?

  • Ceilings at departure airport

  • Forecast Ceilings at Destination

  • 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

  • Do you have onboard weather?

  • Consider NO GO

  • Degree to which deviations are likely to be required

  • Is Icing in the Forecast?

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

  • CONSIDER NO GO

External Pressures

  • Importance of mission

  • Nervous or distracting passenger

  • Self imposed pressure

External Pressures

Additional Factors and Risk Mitigation Strategies

  • Other risk factor

  • Additional Factor
  • Additional risk

  • Impact on Safety

  • Mitigation Possible

  • Explain Mitigation for this risk

  • Plan to take an instructor or experienced pilot.

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