Please provide your the name of your agency. The survey results will be totally anonymous. However, we must be able to identify possible duplicate submissions from the same agency to prevent the results from being skewed.

Agency Name:  

Number, Make and Model aircraft operated since January 1, 1999.
(Please list this information even if your agency has had no accidents or incidents since January 1, 1999.)

 Check this box ONLY if your agency has had no incidents or accidents since January 1, 1999.

If your agency has had no incidents or accidents since January 1, 1999 you may disregard the rest of this survey. Scroll to the bottom and click submit.

Accident/Incident #1

AC Make:
AC Model:

Primary Cause of accident/incident #1:
Select One Engine Failure Tail Rotor Failure Governor Failure Fuel Controller Failure Hydraulic Failure Other Mechanical Failure ---------- Fuel Exhaustion Wire Strike Antenna Strike CFIT Other Surface Obstacle Collision ---------- Loss of Tail Rotor Effectiveness (LTE) Vortex Ring State (settling with power) Dynamic Rollover Other Loss of Control ---------- Disorientation Inadvertent IMC (IIMC) Other Weather Related ---------- External Load Operation ---------- Aeronautical Decision Making Crew Resource Management ---------- Training – Autorotation Training – Hydraulic Failure Training – Tail Rotor Failure Training – Other Other - Not Listed Above - Please leave comments

Associated Cause of accident/incident #1:
Select One Engine Failure Tail Rotor Failure Governor Failure Fuel Controller Failure Hydraulic Failure Other Mechanical Failure ---------- Fuel Exhaustion Wire Strike Antenna Strike CFIT Other Surface Obstacle Collision ---------- Loss of Tail Rotor Effectiveness (LTE) Vortex Ring State (settling with power) Dynamic Rollover Other Loss of Control ---------- Disorientation Inadvertent IMC (IIMC) Other Weather Related ---------- External Load Operation ---------- Aeronautical Decision Making Crew Resource Management ---------- Training – Autorotation Training – Hydraulic Failure Training – Tail Rotor Failure Training – Other Other - Not Listed Above - Please leave comments

Additional Cause of accident/incident #1:
Select One Engine Failure Tail Rotor Failure Governor Failure Fuel Controller Failure Hydraulic Failure Other Mechanical Failure ---------- Fuel Exhaustion Wire Strike Antenna Strike CFIT Other Surface Obstacle Collision ---------- Loss of Tail Rotor Effectiveness (LTE) Vortex Ring State (settling with power) Dynamic Rollover Other Loss of Control ---------- Disorientation Inadvertent IMC (IIMC) Other Weather Related ---------- External Load Operation ---------- Aeronautical Decision Making Crew Resource Management ---------- Training – Autorotation Training – Hydraulic Failure Training – Tail Rotor Failure Training – Other Other - Not Listed Above - Please leave comments

Additional Cause of accident/incident #1:
Select One Engine Failure Tail Rotor Failure Governor Failure Fuel Controller Failure Hydraulic Failure Other Mechanical Failure ---------- Fuel Exhaustion Wire Strike Antenna Strike CFIT Other Surface Obstacle Collision ---------- Loss of Tail Rotor Effectiveness (LTE) Vortex Ring State (settling with power) Dynamic Rollover Other Loss of Control ---------- Disorientation Inadvertent IMC (IIMC) Other Weather Related ---------- External Load Operation ---------- Aeronautical Decision Making Crew Resource Management ---------- Training – Autorotation Training – Hydraulic Failure Training – Tail Rotor Failure Training – Other Other - Not Listed Above - Please leave comments

Comments:

Accident/Incident #2

AC Make:
AC Model:

Primary Cause of accident/incident #2:
Select One Engine Failure Tail Rotor Failure Governor Failure Fuel Controller Failure Hydraulic Failure Other Mechanical Failure ---------- Fuel Exhaustion Wire Strike Antenna Strike CFIT Other Surface Obstacle Collision ---------- Loss of Tail Rotor Effectiveness (LTE) Vortex Ring State (settling with power) Dynamic Rollover Other Loss of Control ---------- Disorientation Inadvertent IMC (IIMC) Other Weather Related ---------- External Load Operation ---------- Aeronautical Decision Making Crew Resource Management ---------- Training – Autorotation Training – Hydraulic Failure Training – Tail Rotor Failure Training – Other Other - Not Listed Above - Please leave comments

Associated Cause of accident/incident #2:
Select One Engine Failure Tail Rotor Failure Governor Failure Fuel Controller Failure Hydraulic Failure Other Mechanical Failure ---------- Fuel Exhaustion Wire Strike Antenna Strike CFIT Other Surface Obstacle Collision ---------- Loss of Tail Rotor Effectiveness (LTE) Vortex Ring State (settling with power) Dynamic Rollover Other Loss of Control ---------- Disorientation Inadvertent IMC (IIMC) Other Weather Related ---------- External Load Operation ---------- Aeronautical Decision Making Crew Resource Management ---------- Training – Autorotation Training – Hydraulic Failure Training – Tail Rotor Failure Training – Other Other - Not Listed Above - Please leave comments

Additional Cause of accident/incident #2:
Select One Engine Failure Tail Rotor Failure Governor Failure Fuel Controller Failure Hydraulic Failure Other Mechanical Failure ---------- Fuel Exhaustion Wire Strike Antenna Strike CFIT Other Surface Obstacle Collision ---------- Loss of Tail Rotor Effectiveness (LTE) Vortex Ring State (settling with power) Dynamic Rollover Other Loss of Control ---------- Disorientation Inadvertent IMC (IIMC) Other Weather Related ---------- External Load Operation ---------- Aeronautical Decision Making Crew Resource Management ---------- Training – Autorotation Training – Hydraulic Failure Training – Tail Rotor Failure Training – Other Other - Not Listed Above - Please leave comments

Additional Cause of accident/incident #2:
Select One Engine Failure Tail Rotor Failure Governor Failure Fuel Controller Failure Hydraulic Failure Other Mechanical Failure ---------- Fuel Exhaustion Wire Strike Antenna Strike CFIT Other Surface Obstacle Collision ---------- Loss of Tail Rotor Effectiveness (LTE) Vortex Ring State (settling with power) Dynamic Rollover Other Loss of Control ---------- Disorientation Inadvertent IMC (IIMC) Other Weather Related ---------- External Load Operation ---------- Aeronautical Decision Making Crew Resource Management ---------- Training – Autorotation Training – Hydraulic Failure Training – Tail Rotor Failure Training – Other Other - Not Listed Above - Please leave comments

Comments:

Accident/Incident #3

AC Make:
AC Model:

Primary Cause of accident/incident #3:
Select One Engine Failure Tail Rotor Failure Governor Failure Fuel Controller Failure Hydraulic Failure Other Mechanical Failure ---------- Fuel Exhaustion Wire Strike Antenna Strike CFIT Other Surface Obstacle Collision ---------- Loss of Tail Rotor Effectiveness (LTE) Vortex Ring State (settling with power) Dynamic Rollover Other Loss of Control ---------- Disorientation Inadvertent IMC (IIMC) Other Weather Related ---------- External Load Operation ---------- Aeronautical Decision Making Crew Resource Management ---------- Training – Autorotation Training – Hydraulic Failure Training – Tail Rotor Failure Training – Other Other - Not Listed Above - Please leave comments

Associated Cause of accident/incident #3:
Select One Engine Failure Tail Rotor Failure Governor Failure Fuel Controller Failure Hydraulic Failure Other Mechanical Failure ---------- Fuel Exhaustion Wire Strike Antenna Strike CFIT Other Surface Obstacle Collision ---------- Loss of Tail Rotor Effectiveness (LTE) Vortex Ring State (settling with power) Dynamic Rollover Other Loss of Control ---------- Disorientation Inadvertent IMC (IIMC) Other Weather Related ---------- External Load Operation ---------- Aeronautical Decision Making Crew Resource Management ---------- Training – Autorotation Training – Hydraulic Failure Training – Tail Rotor Failure Training – Other Other - Not Listed Above - Please leave comments

Additional Cause of accident/incident #3:
Select One Engine Failure Tail Rotor Failure Governor Failure Fuel Controller Failure Hydraulic Failure Other Mechanical Failure ---------- Fuel Exhaustion Wire Strike Antenna Strike CFIT Other Surface Obstacle Collision ---------- Loss of Tail Rotor Effectiveness (LTE) Vortex Ring State (settling with power) Dynamic Rollover Other Loss of Control ---------- Disorientation Inadvertent IMC (IIMC) Other Weather Related ---------- External Load Operation ---------- Aeronautical Decision Making Crew Resource Management ---------- Training – Autorotation Training – Hydraulic Failure Training – Tail Rotor Failure Training – Other Other - Not Listed Above - Please leave comments

Additional Cause of accident/incident #3:
Select One Engine Failure Tail Rotor Failure Governor Failure Fuel Controller Failure Hydraulic Failure Other Mechanical Failure ---------- Fuel Exhaustion Wire Strike Antenna Strike CFIT Other Surface Obstacle Collision ---------- Loss of Tail Rotor Effectiveness (LTE) Vortex Ring State (settling with power) Dynamic Rollover Other Loss of Control ---------- Disorientation Inadvertent IMC (IIMC) Other Weather Related ---------- External Load Operation ---------- Aeronautical Decision Making Crew Resource Management ---------- Training – Autorotation Training – Hydraulic Failure Training – Tail Rotor Failure Training – Other Other - Not Listed Above - Please leave comments

Comments:

Accident/Incident #4

AC Make:
AC Model:

Primary Cause of accident/incident #4:
Select One Engine Failure Tail Rotor Failure Governor Failure Fuel Controller Failure Hydraulic Failure Other Mechanical Failure ---------- Fuel Exhaustion Wire Strike Antenna Strike CFIT Other Surface Obstacle Collision ---------- Loss of Tail Rotor Effectiveness (LTE) Vortex Ring State (settling with power) Dynamic Rollover Other Loss of Control ---------- Disorientation Inadvertent IMC (IIMC) Other Weather Related ---------- External Load Operation ---------- Aeronautical Decision Making Crew Resource Management ---------- Training – Autorotation Training – Hydraulic Failure Training – Tail Rotor Failure Training – Other Other - Not Listed Above - Please leave comments

Associated Cause of accident/incident #4:
Select One Engine Failure Tail Rotor Failure Governor Failure Fuel Controller Failure Hydraulic Failure Other Mechanical Failure ---------- Fuel Exhaustion Wire Strike Antenna Strike CFIT Other Surface Obstacle Collision ---------- Loss of Tail Rotor Effectiveness (LTE) Vortex Ring State (settling with power) Dynamic Rollover Other Loss of Control ---------- Disorientation Inadvertent IMC (IIMC) Other Weather Related ---------- External Load Operation ---------- Aeronautical Decision Making Crew Resource Management ---------- Training – Autorotation Training – Hydraulic Failure Training – Tail Rotor Failure Training – Other Other - Not Listed Above - Please leave comments

Additional Cause of accident/incident #4:
Select One Engine Failure Tail Rotor Failure Governor Failure Fuel Controller Failure Hydraulic Failure Other Mechanical Failure ---------- Fuel Exhaustion Wire Strike Antenna Strike CFIT Other Surface Obstacle Collision ---------- Loss of Tail Rotor Effectiveness (LTE) Vortex Ring State (settling with power) Dynamic Rollover Other Loss of Control ---------- Disorientation Inadvertent IMC (IIMC) Other Weather Related ---------- External Load Operation ---------- Aeronautical Decision Making Crew Resource Management ---------- Training – Autorotation Training – Hydraulic Failure Training – Tail Rotor Failure Training – Other Other - Not Listed Above - Please leave comments

Additional Cause of accident/incident #4:
Select One Engine Failure Tail Rotor Failure Governor Failure Fuel Controller Failure Hydraulic Failure Other Mechanical Failure ---------- Fuel Exhaustion Wire Strike Antenna Strike CFIT Other Surface Obstacle Collision ---------- Loss of Tail Rotor Effectiveness (LTE) Vortex Ring State (settling with power) Dynamic Rollover Other Loss of Control ---------- Disorientation Inadvertent IMC (IIMC) Other Weather Related ---------- External Load Operation ---------- Aeronautical Decision Making Crew Resource Management ---------- Training – Autorotation Training – Hydraulic Failure Training – Tail Rotor Failure Training – Other Other - Not Listed Above - Please leave comments

Comments:

Accident/Incident #5

AC Make:
AC Model:

Primary Cause of accident/incident #5:
Select One Engine Failure Tail Rotor Failure Governor Failure Fuel Controller Failure Hydraulic Failure Other Mechanical Failure ---------- Fuel Exhaustion Wire Strike Antenna Strike CFIT Other Surface Obstacle Collision ---------- Loss of Tail Rotor Effectiveness (LTE) Vortex Ring State (settling with power) Dynamic Rollover Other Loss of Control ---------- Disorientation Inadvertent IMC (IIMC) Other Weather Related ---------- External Load Operation ---------- Aeronautical Decision Making Crew Resource Management ---------- Training – Autorotation Training – Hydraulic Failure Training – Tail Rotor Failure Training – Other Other - Not Listed Above - Please leave comments

Associated Cause of accident/incident #5:
Select One Engine Failure Tail Rotor Failure Governor Failure Fuel Controller Failure Hydraulic Failure Other Mechanical Failure ---------- Fuel Exhaustion Wire Strike Antenna Strike CFIT Other Surface Obstacle Collision ---------- Loss of Tail Rotor Effectiveness (LTE) Vortex Ring State (settling with power) Dynamic Rollover Other Loss of Control ---------- Disorientation Inadvertent IMC (IIMC) Other Weather Related ---------- External Load Operation ---------- Aeronautical Decision Making Crew Resource Management ---------- Training – Autorotation Training – Hydraulic Failure Training – Tail Rotor Failure Training – Other Other - Not Listed Above - Please leave comments

Additional Cause of accident/incident #5:
Select One Engine Failure Tail Rotor Failure Governor Failure Fuel Controller Failure Hydraulic Failure Other Mechanical Failure ---------- Fuel Exhaustion Wire Strike Antenna Strike CFIT Other Surface Obstacle Collision ---------- Loss of Tail Rotor Effectiveness (LTE) Vortex Ring State (settling with power) Dynamic Rollover Other Loss of Control ---------- Disorientation Inadvertent IMC (IIMC) Other Weather Related ---------- External Load Operation ---------- Aeronautical Decision Making Crew Resource Management ---------- Training – Autorotation Training – Hydraulic Failure Training – Tail Rotor Failure Training – Other Other - Not Listed Above - Please leave comments

Additional Cause of accident/incident #5:
Select One Engine Failure Tail Rotor Failure Governor Failure Fuel Controller Failure Hydraulic Failure Other Mechanical Failure ---------- Fuel Exhaustion Wire Strike Antenna Strike CFIT Other Surface Obstacle Collision ---------- Loss of Tail Rotor Effectiveness (LTE) Vortex Ring State (settling with power) Dynamic Rollover Other Loss of Control ---------- Disorientation Inadvertent IMC (IIMC) Other Weather Related ---------- External Load Operation ---------- Aeronautical Decision Making Crew Resource Management ---------- Training – Autorotation Training – Hydraulic Failure Training – Tail Rotor Failure Training – Other Other - Not Listed Above - Please leave comments

Comments: