Transport Logistics Fatigue Assessment Form
Please complete this assessment to help monitor and manage fatigue risks in transport logistics operations.
How would you rate your current level of fatigue?
*
1
2
3
4
5
How many hours of sleep did you get in the last 24 hours?
*
How would you describe the quality of your last sleep period?
*
Very poor
Poor
Fair
Good
Excellent
How many hours have you been on duty since your last rest break?
*
How long was your last rest break?
*
Please Select
Less than 15 minutes
15-30 minutes
31-60 minutes
More than 1 hour
What is your current duty context?
*
Driving
Loading/Unloading
Waiting
Administrative/Other
How alert do you feel right now?
*
Not alert
1
2
3
4
5
6
7
8
9
Fully alert
10
1 is Not alert, 10 is Fully alert
How would you rate the intensity of your workload during this shift?
*
Very low
Low
Moderate
High
Very high
Please indicate how strongly you agree with the following statements regarding your current state.
*
Rows
Strongly disagree
Disagree
Neutral
Agree
Strongly agree
I am struggling to concentrate.
1
2
3
4
5
I feel physically tired.
6
7
8
9
10
I am likely to make mistakes.
11
12
13
14
15
Fatigue is affecting my performance.
16
17
18
19
20
Do you have any safety concerns or incidents to report from this shift?
Submit Assessment
Should be Empty: