Details Of Senior Driver

Senior Driver's First Name

Senior Driver's Last Name

Behaviour & Ability

1. Wears glasses or lenses as per conditions on the back of the driver license
YesNo

2. Can safely operate all vehicle controls
YesNo

3. Follows all traffic laws and road markings
YesNo

4. Remains calm and confident when driving
YesNo

Lateral Road Position & Following Distance

1. Maintains a safe following distance
YesNo

2. Maintains a safe position in their lane
YesNo

3. Safe lateral road position when passing parked objects
YesNo

4. Uses proper procedures at different types of intersections (e.g., stops and give ways, traffic islands, controlled and uncontrolled intersections, etc.)
YesNo

5. Applies Give Way rules correctly at intersections
YesNo

6. Merges into the flow of traffic correctly
YesNo

Observation

1. Observation techniques at intersections
YesNo

2. Observation techniques when changing lanes, merging and in general when changing position on the road
YesNo

3. Regularly checks the rear vision mirror and side mirrors
YesNo

Speed Control

1. Keeps to the maximum speed limit
YesNo

2. Flows with the traffic within the speed limit
YesNo

3. Maintains a steady/consistent speed
YesNo

4. Uses brakes appropriately
YesNo

5. Avoids jerky starts and stops
YesNo

6. Fully stops at stop signs
YesNo

7. Stops at amber lights unless it is unsafe to do so
YesNo

Steering

1. Safe steering in all driving situations
YesNo

2. Maintains correct grip on steering wheel
YesNo

Communication

1. Uses indicators correctly
YesNo

2. Uses horn appropriately
YesNo

Hazard Perception

1. Drives at speed appropriate for conditions
YesNo

2. Aware of hazards and deals with these appropriately
YesNo

Your Recommendation

In your professional opinion do you consider seniorfirstname seniorlastname competent to drive or not competent to drive? (This will be taken into account by the decision-maker regarding this person’s ability to retain their licence as part of their overall assessment).

Competent to drive? SafeNot Safe

Additional Comments

Driving Assessor Details

Assessor's First Name

Assessor's Last Name

Name Of Driving School

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