Transition Skills Assessment Created by Mrs. Medill for Community Participation

Complete the following survey.
Name: 


A red asterisk (*) indicates required questions.

  1. Do you use the telephone to get information on the things you need?*
    Yes
    No


  1. Are you able to find your way around town independently?*
    Yes
    No


  1. When you need to get a rid some place, how do you get there?*
    I walk or ride bike.
    My parents bring me.
    I get a ride from an older brother or sister.
    I have to find a friend to bring me.
    I don't go any place.


  1. Do you use the public library? *
    Yes
    No


  1. Do you have a bank account? (savings, checking, other)*
    Yes
    No


  1. Do you use the post office to mail letters or packages?*
    Yes
    No


  1. Have you had an appointment with a doctor for your health, check ups, or shots in the last three years?*
    Yes
    No


  1. Are you able to get to unfamiliar places by following a map or asking for directions?*
    Yes
    No


  1. What church do you belong to? (write none if you do not have one)*


  1. Which best explains how you do laundry?  *


  1. What restaurants do you go to?*





Mr. Burns
Worthington Middle School
Worthington, MN