Appendix D Personal Minimums Checklist Pilot:_________________________________ Date Revised: _________________________ Reviewed with: ________________________                   (if applicable) Your Personal Minimums Checklist Is an easy-to-use, personal tool tailored to your level of skill, knowledge, and ability. Helps you control and manage risk by identifying even subtle risk factors. Allows you to fly with less stress and less risk. Practice “Conservatism Without Guilt.” Each item provides you with either a space to complete a personal minimum or a checklist item to think about. Spend some quiet time completing each blank and consider other items that apply to your personal minimums. Give yourself permission to choose higher minimums than those specified in the regulations, aircraft flight manuals, or other rules. How To Use Your Checklist Use this checklist just as you would use one for your aircraft. Carry the checklist in your flight kit. Use it at home as you start planning a flight and again just before you make your final decision to fly. Be wary if you have an item that’s marginal in any single risk factor category. But if you have items in more than one category, you may be headed for trouble. If you have marginal items in two or more risk factors/categories, do not go! Periodically review and revise your checklist as your personal circumstances change, such as your proficiency, recency, or training. You should never make your minimums less restrictive unless a significant positive event has occurred. However, it is okay to make your minimums more restrictive at any time. And never make your minimums less restrictive when you are planning a specific flight, or else external pressures will influence you. Have a fun and safe flight! PILOT Experience/Recency Takeoffs/landings..................... _____ in the last _____ days Hours in make/model ................ _____ in the last _____ days Instrument approaches ............ _____ (simulated or actual) in the last _____ days Instrument flight hours ............._____ (simulated or actual) in the last _____ days Terrain and airspace ................. familiar Physical Condition Sleep ........................................ _____ hours in the last 24 hours Food and water ................................... in the last _____ hours Alcohol .............................................. None in the last _____ hours Drugs or medication.............................. None in the last _____ hours Stressful events .................................. None in the last _____ days Illnesses ............................................ None in the last _____ days

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