Information

  • Student Name

  • Address
  • Telephone
  • Assessment Document No.

  • Licence Number & Version

  • Assessment Conducted on

  • Driving Instructor

  • Location of Assessment
  • Start Date & Time of Drive

Turning Right at a Controlled Intersection STOP or GIVE WAY

  • How well did you check the MIRROR and SEARCH

  • Observation

  • How well did you choose your GAP.

  • Gap Selection

  • How well did you choose your SPEED

  • Speed choice at various situations

  • How well did you select your SIGNALS

  • Signals

  • How well did you check and keep your FOLLOWING DISTANCE

  • Following Distance

  • CRITICAL ERRORS

  • IMMEDIATE FAIL ERRORS

  • Hazards Detected

  • Hazard Detection

  • Hazard Response

Changing Lanes, Straight Road LEFT TO RIGHT or RIGHT TO LEFT

  • How well did you check the MIRROR and SEARCH

  • Observation

  • How well did you choose your GAP.

  • Gap Selection

  • How well did you choose your SPEED

  • Speed choice at various situations

  • How well did you select your SIGNALS

  • Signals

  • How well did you check and keep your FOLLOWING DISTANCE

  • Following Distance

  • CRITICAL ERRORS

  • IMMEDIATE FAIL ERRORS

  • Hazards Detected

  • Hazard Detection

  • Hazard Response

Turning Right Across a Multiple Lane

  • How well did you check the MIRROR and SEARCH

  • Observation

  • How well did you choose your GAP.

  • Gap Selection

  • How well did you choose your SPEED

  • Speed choice at various situations

  • How well did you select your SIGNALS

  • Signals

  • How well did you check and keep your FOLLOWING DISTANCE

  • Following Distance

  • CRITICAL ERRORS

  • IMMEDIATE FAIL ERRORS

  • Hazards Detected

  • Hazard Detection

  • Hazard Response

Turning Right at a Roundabout

  • How well did you check the MIRROR and SEARCH

  • Observation

  • How well did you choose your GAP.

  • Gap Selection

  • How well did you choose your SPEED

  • Speed choice at various situations

  • How well did you select your SIGNALS

  • Signals

  • How well did you check and keep your FOLLOWING DISTANCE

  • Following Distance

  • CRITICAL ERRORS

  • IMMEDIATE FAIL ERRORS

  • Hazards Detected

  • Hazard Detection

  • Hazard Response

Turning Right at a Controlled Intersection STOP or GIVE WAY

  • How well did you check the MIRROR and SEARCH

  • Observation

  • How well did you choose your GAP.

  • Gap Selection

  • How well did you choose your SPEED

  • Speed choice at various situations

  • How well did you select your SIGNALS

  • Signals

  • How well did you check and keep your FOLLOWING DISTANCE

  • Following Distance

  • CRITICAL ERRORS

  • IMMEDIATE FAIL ERRORS

  • Hazards Detected

  • Hazard Detection

  • Hazard Response

Turning Left into a Multiple Lane

  • How well did you check the MIRROR and SEARCH

  • Observation

  • How well did you choose your GAP.

  • Gap Selection

  • How well did you choose your SPEED

  • Speed choice at various situations

  • How well did you select your SIGNALS

  • Signals

  • How well did you check and keep your FOLLOWING DISTANCE

  • Following Distance

  • CRITICAL ERRORS

  • IMMEDIATE FAIL ERRORS

  • Hazards Detected

  • Hazard Detection

  • Hazard Response

Turn Right at Uncontrolled Intersection

  • How well did you check the MIRROR and SEARCH

  • Observation

  • How well did you choose your GAP.

  • Gap Selection

  • How well did you choose your SPEED

  • Speed choice at various situations

  • How well did you select your SIGNALS

  • Signals

  • How well did you check and keep your FOLLOWING DISTANCE

  • Following Distance

  • CRITICAL ERRORS

  • IMMEDIATE FAIL ERRORS

  • Hazards Detected

  • Hazard Detection

  • Hazard Response

Turn Right at Uncontrolled Intersection

  • How well did you check the MIRROR and SEARCH

  • Observation

  • How well did you choose your GAP.

  • Gap Selection

  • How well did you choose your SPEED

  • Speed choice at various situations

  • How well did you select your SIGNALS

  • Signals

  • How well did you check and keep your FOLLOWING DISTANCE

  • Following Distance

  • CRITICAL ERRORS

  • IMMEDIATE FAIL ERRORS

  • Hazards Detected

  • Hazard Detection

  • Hazard Response

  • Mike Hartle Driving Instructor RoadSmart Driver Training

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.