Offshore Fatigue Survey

Description:

Please fill in this survey before taking the Alertness Test (PVT).

Question 12 is for any general comments - feel free to add anything you feel is relevant.

Question 13 is to include your itinerary if travelling to work.

Thanks for your assistance, contact me on wpralph@googlemail.com for any issues / questions.


What is your participant ID #?





















What is todays date?

What is the current time?

What day of the swing are you on?


































What shift are you currently working?








On a scale of 1 - 10 with 10 being most tired, how tired do you feel right now?





How many hours sleep did you get the last time you went to bed?

0
250
500

How would you describe the quality of your last sleep period?





If your sleep quality was very poor or below average please detail any reasons you think may have contributed for this below. Skip this question if a

How many hours have you been awake now?

0
250
500

Was your last sleep period as part of short change?



At any time today did you feel fatigued? And if so what actions did you take to remain alert (Coffee; walk outside; etc) and how effective were they?

If today was a travel day please type your routing and flight durations below (Itinerary). Skip this question if not applicable.