RW INCIDENT REPORT

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CONTACT JARED FRIEND
AT (541) 941-5157
IMMEDIATELY
AFTER SUBMISSION
This SMS Report can be discretely filled out and submitted on your Mobile Device at this link
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Name *
Event Type
Event Date *
Event Time *
 hh:mm
Location and Equipment
N Number
Aircraft Type
Nearest Airport *
Based at
Phase of Flight
Weather Factors
PIC Duty Time
Event Details
# of Instructors
CFI Name
# of Students
Ops Part
# of Passengers
Flight Type
Pilot Name
Email
 Email
Event Description (One Sentence Summary) (250 Characters)
Describe the Incident & Sequence of Actions (1500 Characters)
What Different Actions Could Have Reduced or Mitigated Risk
What Additional Resources Could Have Reduced or Mitigated Risk
This Incident May Have Caused a Regulatory Deviation or Violation
This Incident was Non-Compliant with HAA SOP's and/or Policies & Procedures
Attach Images/Files to report:
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CONTACT JARED FRIEND AT (541) 941-5157
IMMEDIATELY AFTER SUBMISSION