Aerial Rescue Skills Assessment
Evaluate and document the skills and competencies of individuals performing aerial rescue operations.
Participant Full Name
*
First Name
Last Name
Email Address
*
example@example.com
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Date of Assessment
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Hour Minutes
AM
PM
AM/PM Option
Assessor Full Name
*
First Name
Last Name
Role/Position of Participant
*
Please Select
Rescue Technician
Team Leader
Trainee
Observer
Other
Relevant Certifications Held (select all that apply)
Rope Rescue Certification
First Aid/CPR
Aerial Rescue Training
None
Other
Years of Experience in Aerial Rescue
*
Aerial Rescue Skills Assessment Matrix
*
Rows
Needs Improvement
Satisfactory
Excellent
Proper use of PPE
1
2
3
Knot tying proficiency
4
5
6
Rigging and anchor systems
7
8
9
Communication during rescue
10
11
12
Victim assessment and care
13
14
15
Execution of rescue scenario
16
17
18
Scene safety management
19
20
21
Scenario-Based Assessment: Select the scenario(s) assessed and rate performance.
*
Rows
Not Attempted
Attempted with Assistance
Completed Independently
Completed with Excellence
Tower rescue
22
23
24
25
Confined space rescue
26
27
28
29
High-angle rescue
30
31
32
33
Helicopter extraction
34
35
36
37
Overall Performance Rating
*
1
2
3
4
5
Assessor Comments and Recommendations
Assessor Signature
*
Submit Assessment
Submit Assessment
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