Fatigue / Fitness-for-Duty Report

Severity 4 or 5

FRMP §4.1 requires you to notify the Chief Pilot directly, or the Director of Safety or Director of Operations if the Chief Pilot is unavailable. Make the call. This form does not replace it.

Your name

A name is required because the response is personal: a schedule change, a trip, a duty status. The full report goes to the Chief Pilot and the Director of Safety only. Anyone else is told only what their role requires (FRMP §5.8).

Crewmember position

Affected duty date

The duty this affected, or will affect. Today if you are on duty now.

Trip or duty affected

Optional. Helps the Chief Pilot adjust the schedule. Leave blank if no trip is affected.

Duty timing

Expected duration

How long you expect this to affect you. Pick Unknown if you cannot say.

What are you reporting

Select everything that applies.

What happened

Short is fine. What is going on, and anything that caused it.

I understand this report is non-punitive FRMP §2.2. No crewmember is disciplined for reporting fatigue, asking for mitigation, or removing themselves from duty.

Submitting notifies the Director of Safety and the Chief Pilot. The report does not determine fitness for duty, clearance, or return to duty.

Report received