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In Car Script - Harlow

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Assessment Details

In Car Assessment - Harlow - 14 Mile Route

Client Name *

First

Last

Assessment Date and Time

Date

Time

Vision and Eyesight

Were corrective lenses or glasses required?

Yes
No

Has the candidate met the vision requirements?

Pass
Fail

Stationary Transfer

Passenger's Seat - Independent
Passenger's Seat - Assisted
Driver's Seat - Independent
Driver's Seat - Assisted

State what assistance was required

Vehicle

MAKE of Vehicle

MODEL of Vehicle

Controls Used

Manual
Automatic

Vehicle Adaptations Used

Weather

Sunny and Clear
Cloudy and Overcast
Light Rain
Heavy rain
Snow
High wind
Fog / Mist

Familiarisation, Accessibility and Safety

START Time - Familiarisation

Use the '24 hour' format, eg. "14:30"

FINISH Time - Familiarisation

Use the '24 hour' format, eg. "14:30"

START Time - On Road

Use the '24 hour' format, eg. "14:30"

FINISH Time - On Road

Use the '24 hour' format, eg. "14:30"

Emergency Stop Exercise

1
2
3
4

Problems Noted During Familiarisation

On Road Assessment

1 - Turn left out of car park onto Edinburgh Way (60mph straight road)

1
2
3
4

Notes

2 - At the next roundabout (McDonalds) turn right, 3rd exit into Howard Way

1
2
3
4

Notes

3 - Straight ahead no instruction at next 2 roundabout

1
2
3
4

Notes

4 - Ask the speed limit (40mph)

1
2
3
4

Notes

5 - Crossing, traffic lights - Take the next available left (Morples Road)

1
2
3
4

Notes

6 - Ask the speed limit (20mph)

1
2
3
4

Notes

7 - Parallel Park

1
2
3
4

Notes

Opportunity to pull over and give feedback:

8 - Give Way and pinch point

1
2
3
4

Notes

9 - At the end of the road turn right

1
2
3
4

Notes

10 - Follow the signs to Chelmsford A414 (3rd exit)

1
2
3
4

Notes

11 - Ask the speed limit (50mph)

1
2
3
4

Notes

12 - Traffic lights, single lane traffic merging from left

1
2
3
4

Notes

13 - Straight ahead at roundabout - 2nd exit

1
2
3
4

Notes

14 - At the next roundabout turn left first exit - Potten Street

1
2
3
4

Notes

15 - Ask the speed limit (20mph)

1
2
3
4

Notes

16 - Straight ahead (onto London Road)

1
2
3
4

Notes

17 - Take next left after pub into Harlow Common

1
2
3
4

Notes

18 - Ask the speed limit (40mph)

1
2
3
4

Notes

19 - Take the 1st right straight after M11 bridge into Mill Street

1
2
3
4

Notes

20 - Turn right at blind ‘T’ Junction

1
2
3
4

Notes

21 - Self-navigation - follow signs to Epping (2nd exit)

1
2
3
4

Notes

22 - Ask the speed limit (60mph)

1
2
3
4

Notes

23 - Take the next right onto Rye Hill Road

1
2
3
4

Notes

24 - Bendy road which is 60mph

1
2
3
4

Notes

25 - At the ‘T’ junction turn right into Paringdon Road

1
2
3
4

Notes

26 - At ‘Royce’ mini roundabout turn left onto Tillwicks Road

1
2
3
4

Notes

27 - Turn left at the next roundabout onto Second Avenue (could go straight over to get back to centre)

1
2
3
4

Notes

28 - Self-navigation to train station - Water Garden's roundabout 2nd exit

1
2
3
4

Notes

29 - Straight ahead at next roundabout

1
2
3
4

Notes

30 - Sainsbury's roundabout - ahead

1
2
3
4

Notes

31 - Cancel self-navigation - at roundabout take the 4th exit - A414 to Chelmsford

1
2
3
4

Notes

32 - Toby Carvery straight ahead

1
2
3
4

Notes

33 - Take the next left into the centre

1
2
3
4

Notes

34 - Parking bay manoeuvre

1
2
3
4

Notes

ASSESSMENT END TIME

Use the '24 hour' format, eg. "14:30"

Back to the Hub

Results

Physical intervention by the ADI

Dual Brake
Took control of the steering wheel
Any other physical intervention e.g. gears, indicators (please specify)

Intervention frequency: Dual Brake

Intervention frequency: Steering Wheel

Intervention frequency: Gears, Indicators etc

Assessment Result

Safe
Inconclusive
Unsafe

Length of Route

4 mile
8 mile
11 mile (Full Route)
Other (please specify)

Specify length of route (if applicable)

Additional Notes

ADI and OT analysis

Did client agree with my opinion?

Did the client believe that they drove safely?

Was client happy with the choice of controls?

Advice given / Plan

Who was present during the recommendations?

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