Ground to Cockpit Communication Procedure Checklist Form
Use this form to document and verify compliance with ground-to-cockpit communication procedures. Ensure each checklist item is reviewed and any issues are reported.
Flight or Operation Identifier
*
Date and Time of Communication
*
-
Month
-
Day
Year
Date
Hour Minutes
AM
PM
AM/PM Option
Ground Crew Name or ID
*
Cockpit Crew Name or ID
*
Communication Channel Established
*
Please Select
Radio
Intercom
Headset
Other
Initial Contact Confirmed
*
Ground crew greeted cockpit
Cockpit acknowledged ground crew
Critical Instructions Delivered and Acknowledged
*
Pushback/Taxi clearance delivered
Cockpit read back instructions
Ground confirmed read back
Communication Equipment Functioned Properly
*
Please Select
Yes
No
Any Issues or Irregularities Encountered?
*
No issues encountered
Audio clarity issues
Lost communication
Other (please specify below)
Additional Notes or Comments
Submit Checklist
Should be Empty: