For Teens Only Transition Checklist
For Teens Only Transition Checklist
This checklist should be followed by all teens, their families, and health
care providers. It should be adjusted according to the teen's developmental ability.
Health Care Skills
StartDate
Reviewed
GoalsComplete
Meet independently (as able) with health care providers
For history and physical exam at age 14-16
For complete visit including treatment recommendations at age 18 and over
     
Understands medical condition
Diagnosis
Changes/symptoms caused by medical condition and effect on daily life
Treatments and medications including use, side effects, interactions
Laboratory tests and procedures needed
Medic Alert bracelet/necklace
Long term complications of chronic condition
     
Manages Own Health Care
StartDate
Reviewed
GoalsComplete
Makes own medical appointments
     
Can tell when changes/symptoms require medical attention
     
Refills medications and supplies, proper disposal of used supplies.
     
Can tell when to replace durable medical equipment, need for extra back-ups
     
Knows how to hire personal care assistants and is responsible for their supervision
     
Responsibly manages daily treatments
     
Knows medications and what they're for: Carries information in wallet or purse
     
Knows health emergency phone numbers: Carries information in wallet or purse
     
Knows what to do in a medical emergency
     
Has identified an adult health provider/facility
     
Has considered genetic counseling and knows genetic risks if applicable
     
Knows nature and levels of sexual activity related to health condition
     
Consents to medical care, prepares and asks questions of medical health care providers
     
If unable to make own health care decisions, complete process for appointing legal guardian
     
Accesses information and responds to health providers' questions
     
Knowledge of Health Insurance
StartDate
Reviewed
GoalsComplete
Knows medical insurance coverage:
Carries card in wallet or purse
Knows insurance requirements regarding covered providers, referrals, pre- certifications
     
Knowledge of Resources
StartDate
Reviewed
GoalsComplete
Knows how to apply for insurance/income assistance, including Medicaid/ Medicare
     
Contacts appropriate services and agencies for assistance
     
Knows how to use community transportation if needed
     
Knows that he/she may have a 504 plan or IEP and benefits of these plans for school or vocational center
     
Health Records
StartDate
Reviewed
GoalsComplete
Knows how to access health information
     
Has consented to transferring medical health records to new provider
     
Has consented to release of information to parents or other providers after age of 18
     
Has and uses a planner for appointments
     
Education
StartDate
Reviewed
GoalsComplete
Knows that federal law requires that transition planning begin at age 14
     
Knows that at age 16, transition services must be included in IEP evaluations
     
Knows his/her educational rights (504, IDEA, ADA)
     
Knows his/her interests, skills, strengths and challenges
     
Knows his/her educational goals and transition plans
     
Knows how to make decisions independently
     
Knows which resources and services end at certain age, or high school or college graduation
     
Plans for Independent Living
StartDate
Reviewed
GoalsComplete
  • Have plans about living arrangements:
  • Live alone
  • Live with parent/guardian
  • Live in group home
  • Live with other adults
  • Other_____________________________
  • Modifications required based on needs
____________________________________
     
Have an emergency evacuation plan
     
Plans for employment, school, vocational programs
     
  • Knows financial responsibilities such as:
  • Paying bills
  • Utilities
  • Manage a checking account
  • Budgeting
  • Savings
  • Medical costs
     
Notify utility companies and emergency services of special needs
     

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