TRANSITION READINESS ASSESSMENT

No, I do not know how

No, but I want to learn

No, but I am learning

Yes, I have started doing it

Yes, I do it when I need to

Managing Medications

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1. Do you fill a prescription if you need to?
2. Do you know what to do if you are having a bad reaction to your medications?
3. Do you take medications correctly and on your own?
4. Do you reorder medications before they run out?

Appointment Keeping

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5. Do you call the doctor's office to make an appointment?
6. Do you follow-up on any referral for tests, check-ups, or labs?
7. Do you arrange your ride to medical appointments?
8. Do you call the doctor about unusual changes in your health? (ex: allergic reactions)
9. Do you apply for health insurance if you lose your current coverage?
10. Do you know what your health insurance covers?
11. Do you manage your money and budget household expenses? (ex: checking/debit card)

Tracking Health Issues

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12. Do you fill out the medical history form, including a list of your allergies?
13. Do you keep a calendar or list of medical or other appointments?
14. Do you make a list of questions before the doctor’s visit?
15. Do you get financial help with school or work?

Talking with Providers

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16. Do you tell the doctor or nurse what you are feeling?
17. Do you answer questions that are asked by the doctor, nurse, or clinical staff?

Managing Daily Activities

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18. Do you help plan or prepare meals/food?
19. Do you keep home/room clean or clean-up after meals?
20. Do you use neighborhood stores and services? (ex: grocery stores & pharmacies)