MY FUTURE ACTIONS WORKSHEET
I WILL
ALREADY
DO
PLAN
TO DO
MY NOTES
DONE
UNIT 1: WHY ARE WE HERE?
Identify gaps in my knowledge/skills
Track my plans and successes on this worksheet
Other:
UNIT 2: HOW DO WE NAVIGATE CHANGES?
Know how my medications interact
Have my hearing and vision tested
Use corrective lenses or hearing aids as needed
Other:
UNIT 3: ARE WE READY TO DRIVE?
Keep my vehicle and tires in safe condition
Correctly use all my vehicle's safety features
Know the rules of the road and all signage
Other:
UNIT 4: ARE WE SMART ON THE ROAD?
Pay attention to what is around me
Eliminate distractions when driving
Never over drive my vision
Never drive when fatigued
Maintain a safe space cushion/following distance
Share the road safely with other users
Other:
UNIT 5: WHAT DOES THE ROAD AHEAD LOOK LIKE?
including trying out each option
Evaluate what driving means to me
Other:
UNIT 6: WHAT CHANGES DO WE NEED TO MAKE?
Identify the most important thing I will do
Make the most important change
Other:
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