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Tools & Checklists

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Utah Integrated Services--Medical Home Project (UISP)

  • Respecting the Young Adult Video (UISP)
    An 8-minute video of a panel discussion of young adults with special healthcare needs offering their perspectives to healthcare providers to improve sensitivity; Utah Integrated Services Medical Home Project.

Toolkits

  • Youth Leadership Toolkit
    Guidebook to go with videos by and for youth and young adults to help them learn about employment and related topics in an easy access online format. Developed by the Center for Persons with Disabilities and the Becoming Leaders for Tomorrow Project in collaboration with the Independent Living Research Utilization (ILRU). Videos available on YouTube at https://www.youtube.com/playlist?list=PLp3WC9HvngxfKsG-YdS0LwzNTHcnnlW5Q.
  • Transition Timeline (PDF Document 32 KB)
    This sample timeline from the Intermountain Collaborative, for ages 2-22, provides suggestions for things that parents and providers should be teaching and checking as children transition through different age ranges and on to adulthood.
  • Utah Parent Center - Transition from School to Adult Life
    The Utah Parent Center has created a handbook, a series of video modules, and a series of information sheets that will help parents and their students to plan for a successful transition from school services to adult life.
  • It's Time to Transition: A Workbook For Young Adults (PDF Document 45 KB)
    This transition workbook is hosted on the Colorado Department of Public Health and Environment web site and was developed by Laura Pickler, MD. The workbook includes forms for gathering contact information, emergency information, care plans, general medical information, insurance information, the young adults' story, and other transition-related information.
  • Full Life Ahead Foundation
    Provides the "Full Life Ahead: A Workbook and Guide to Adult Life for Students and Families of Students with Disabilities." This guide was created to offer parents and students the tools and information necessary to plan for their future. Developed and written by parents and students for other parents and students, this guide can help families successfully work through the transition process.
  • P.R.O. Filer Personal Portfolio & Filing System (PDF Document 160 KB)
    Provides file dividers for the documents at the link above. Published by the Institute on Community Integration. See the companion Personal Portfolio Manual. For more tools, see the All Means All School-to-Work web site at http://ici.umn.edu/all/.
  • Personal Portfolio Manual (PDF Document 151 KB)
    P.R.O. filer - Personal Portfolio and Filing System (2000) gives a helpful guide to organizing documents for youth and young adults with disabilities.. Published by the Institute on Community Integration. See the companion P.R.O. Filer Personal Portfolio & Filing System.

Medical Summaries

  • Medical Summary (Word Document 35 KB)
    This sample summary or individual health plan provides a way to keep track of personal contact information, diagnoses, problems, medications, immunizations, providers, specialists, medical equipment, and more.
  • Portable Medical Summary (PDF Document 70 KB)
    A 2-page form to keep track of medical information including diagnoses, medications, equipment, hospitalizations, and insurance.
  • Transition Summary (PDF Document 12 KB)
    This sample summary form can be adapted and includes diagnosis, medications, surgical history, and more.
  • Transition Referral Form (PDF Document 22 KB)
    Sample form to track referrals to other agencies providing transition services. From the Collaborative Medical Home Project.
  • Family History (Word Document 110 KB)
    An example of a log to note family history of health conditions.
  • Care Notebook
  • All About Me (Word Document 415 KB)
    This 31-page transition notebook for teens has forms for information including emergency contact; providers; personal and family history; insurance; appointments; and medications. The first page has a place to put your picture and the last few pages have a brief listing of suggested state (Okalahoma) and national resources. (Word version for adding information.)

Transition Screening Tools

  • Transition-Screening Tool (Word Document 39 KB)
    Sample screening tool that addresses various transition topics including health, transportation, psychosocial, legal rights, employment, and more. From the Collaborative Medical Home Project.
  • Autonomy Checklist (Word Document 45 KB)
    A sample checklist that includes an extenisve list of home skills; health care skills; community skills; lesisure skills; vocational options; and living arrangements; from the University of Washington.
  • Life Map 14-16 Year Old (PDF Document 34 KB)
    A self-assessment for the young person that covers staying healthy, managing healthcare, independence, emotional health, and school & work; from Kentucky Cabinet for Health Services.
  • Ready Set Go Checklist (PDF Document 3.4 MB)
    A series of checklists to help young people think about planning for their future: Ready, Get Set, Go. Provided by Rhode Island Department of Health and adapted from Bloorview Kids Rehab, Toronto, CA.

Assessment

Action Plans

Healthy Lifestyles

  • Changing Bodies: What's Happening to Me? (PDF Document 43 KB)
    This handout provides brief information about puberty for girls and boys; from the Kentucky Commission for Children with Special Health Care Needs.
  • Making Choices: Are You Ready? (PDF Document 43 KB)
    This handout provides brief information about healthy relationships and sex; from the Kentucky Commission for Children with Special Health Care Needs.
  • Plan Your Health, Live Your Life (PDF Document 8.1 MB)
    Transitions are for everyone. This 6-page planning document has information for teens as they become adults including career goals, health, pregnancy planning, immunizations, STIs, personal safety, emotional health, finances, and more; developed by the Utah Department of Health and collaborative partners.
  • Self-Exams for Females (PDF Document 33 KB)
    This handout provides brief information about how to do a breast self-exam; from the Kentucky Commission for Children with Special Health Care Needs.
  • Self-Exams for Males (PDF Document 42 KB)
    This handout provides brief information about how to do a testicular self-exam; from the Kentucky Commission for Children with Special Health Care Needs.
  • Staying Regular (PDF Document 43 KB)
    This handout provides brief information about how to keep regular bowel movements; from the Kentucky Commission for Children with Special Health Care Needs.
  • Clean Teeth (PDF Document 33 KB)
    This handout provides brief information about brushing and flossing teeth; from the Kentucky Commission for Children with Special Health Care Needs.
  • Exercise (PDF Document 34 KB)
    This handout provides brief information about exercising; from the Kentucky Commission for Children with Special Health Care Needs.
  • Recreation (PDF Document 124 KB)
    This handout provides brief information for teens and young adults about recreation, leisure, and social activities; from the Institute for Community Inclusion at Children's Hospital, Boston.

Health Care

  • Taking Charge of Your Health Care (PDF Document 117 KB)
    From the Institute for Community Inclusion at Children's Hospital, Boston, this handout provides a list of items for adolescents and young adults to consider as they transition to adulthood and begin using adult health care services.
  • Health Transition Tools (Word Document 102 KB)
    This 4-page handout provides a list of tools and web sites that provide transition information for youth, young adults, families, and providers; from Healthy and Ready to Work, www.hrtw.org
  • Finding Adult Health Care
  • Communicating with Doctors and Other Health Care Providers (PDF Document 126 KB)
    From the Institute for Community Inclusion at Children's Hospital, Boston, this handout provides tips to help youth and young adults talk to health care professionals as they transition to adulthood and begin using adult health care services.
  • Growing Up (Word Document 118 KB)
    A fact sheet about planning the the health care transition of youth with special health care needs; topics include health care finance, guardianship, SSI, medical home, and how Family Voices can help; from the Utah Family Voices Health Information & Support Center.
  • Health Insurance Tips (PDF Document 34 KB)
    One-page of tips on health insurance from the Kentucky Commission for Children with Special Health Care Needs.
  • Medication Tips (PDF Document 35 KB)
    One-page of tips about taking and monitoring medications from the Kentucky Commission for Children with Special Health Care Needs.

Education and Employment

  • Transition - Education (PDF Document 119 KB)
    This handout provides tips to help youth and young adults get the services they need from schools, and suggests things to consider in transitioning to college and beginning to use adult health care services. From the Institute for Community Inclusion at Children's Hospital, Boston.
  • Jobs: What Job Do You Do? (PDF Document 42 KB)
    This handout provides brief information about jobs including considering talents, experiences, and benefits or working; from the Kentucky Commission for Children with Special Health Care Needs.
  • Employment (PDF Document 120 KB)
    From the Institute for Community Inclusion at Children's Hospital, Boston, this handout provides helpful tips for youth and young adults to prepare for a job as they transition to adulthood.
  • Life After High School (PDF Document 43 KB)
    This handout provides brief information for planning for college or work after graduation; from the Kentucky Commission for Children with Special Health Care Needs.
  • Living Away From Home (PDF Document 37 KB)
    This handout provides brief tips for young adults as they consider living on their own; from the Kentucky Commission for Children with Special Health Care Needs.
  • Use SSI to Get Ready for Your Future (PDF Document 33 KB)
    This handout provides brief tips for young adults as they consider how work will impact their SSI and Medicaid Benefits; from the Kentucky Commission for Children with Special Health Care Needs.
  • Vocational Rehabilitation (PDF Document 77 KB)
    This handout provides brief tips for young adults as they consider work, vocational rehabilitation, and independent living centers; from the Kentucky Commission for Children with Special Health Care Needs.

Patient Resources

  • Youth/Young Adult Transition Needs Assessment (Word Document 91 KB)
    Provides a user-friendly worksheet to help the youth or young adult with special health care needs prepare for transition to adulthood; from the Utah Family Voices Health Information & Support Center, adapted from Florida.
  • Waisman Center Transition
    Waisman Center, University Center for Excellence in Developmental Disabilities (UCEDD) at the University of Wisconsin-Madison. Includes general disability-related resources including links to many organizations related to transition to adulthood, carrers, independent living, employment, health, education, transportation, benefits, and more.
  • Answers 4 Families
    From the Nebraska Transition Project, this site provides information on healthcare, employment, education, life skills, and other topics. Information includes handouts, videos, and links to other sites.
  • Americans with Disabilities Act (PDF Document 64 KB)
    This handout provides brief information for families about the ADA. Adapted from the Kentucky Commission for Children with Special Health Care Needs.
  • Adolescent Health Transition Project (University of Washington)
    Resource for adolescents with special health care needs, chronic illnesses, and physical or developmental disabilities to understand the transitioning of healthcare and education to adulthood systems; Center on Human Development and Disability at the University of Washington.
  • Social Security Work Site
    Promotes the employment of Social Security beneficiaries.
  • Kentucky Transition Resources
    From the Kentucky Cabinet for Health and Family Services, Commission for Children with Special Health Care Needs, downloadable printable teaching sheets for your patients on topics such as staying healthy, managing their own healthcare, future planning, working, and more.
  • DSCC Transition Resources for Families
    Division of Specialized Care for Children (DSCC), from the University of Illinois at Chicago, provides transition information from childhood to adulthood including fact sheets, tools, transition timelines, and other materials for families.
  • Kids as Self-Advocates (KASA)
    KASA is a national, grassroots network of youth with special needs and friends, speaking on behalf of ourselves. We are leaders in our communities, and we help spread helpful, positive information among our peers to increase knowledge around various issues. Those issues include: living with special health care needs, health care transition issues, education, employment, and many more. We also help health care professionals, policymakers and other adults in our communities understand what it's like to live with special health care needs and we participate in discussions about how to help each other succeed.
  • Independent Living Institute
    This non-profit organization in Europe provides information, educational materials and an on-line library on disability rights and independent living issues.
  • Utah Transitions to the Future (PDF Document 1.5 MB)
    This flyer from Intermountain Sandy Clinic (Medical Home) offers tips and Salt Lake area transition resources for families of youth with special health care needs. Resources include mental health, independent living, driving, guardianship, jobs, community supports, and other resources.

Shriner's Hospital for Children

  • Intermountain Care Coordination/Transition Resource Guide 2003 (Word Document 290 KB)
    Intermountain Care Coordination/Transition Resource for services in Utah, 2003, 89 pages.
  • Transition Tips for Parents of Newborns or Newly Diagnosed Children with Disabilities (PDF Document 483 KB)
    This pamphlet developed by Shriners Hospital for Children, also called A New Start, provides information for parents on coping, staying strong, building hope, utilizing resources, and using health care efficiently.
  • Transition Tips for Parents of Young Children with Disabilities (PDF Document 447 KB)
    This pamphlet developed by Shriners Hospital for Children, also called First Steps, provides information for parents on helping a child stay physically and emotionally healthy; beginning to involve a child in her own health care; encouraging independence; and resources and websites.
  • Transition Tips for Parents of School Aged Children with Disabilities (PDF Document 488 KB)
    This pamphlet developed by Shriners Hospital for Children, also called Stepping Up, provides information for parents on teaching a child to take care of personal needs; helping a child become more involved with her own health care; helping a child stay physically and emotionally healthy; helping a child become more independent; helping a child succeed in school; and resources and websites.
  • Transition Tips for Teens with Disabilities (PDF Document 308 KB)
    This pamphlet, developed by Shriners Hospital for Children, provides information for teens on staying physically and emotionally healthy, taking charge of their own health care, succeeding in school, preparing for work, getting ready for the future, and includes a list of other resources and websites.
  • Transition Tips for Parents of Teens with Disabilities (PDF Document 476 KB)
    This pamphlet, developed by Shriners Hospital for Children, provides information for parents on taking care of themselves, helping teens stay physically and emotionally healthy, addressing sexuality, helping teens succeed in school and work, teaching teens to manage their own health care and become more independent, and includes a list of other resources and websites.
  • Tips for Getting a Driver's License for Teens and Young Adults with Disabilities (PDF Document 360 KB)
    This pamphlet developed by Shriners Hospital for Children, also called On the Road, provides information on where to start to get a drivers license; getting a drivers license in Utah; the Functional Ability Evaluation Medical Report; driving evaluations; adaptive equipment and specialized drivers training; and resources and websites.
  • Transition Tips for Young Adults (PDF Document 348 KB)
    This pamphlet developed by Shriners Hospital for Children, also called Moving On, provides information for young adults on moving to adult health care, paying for health care, preparing for the future, getting around in the community, and becoming more independent. It also offers a list of other resources and websites.
  • Transition Tips for Parents of Young Adults with Disabilities (PDF Document 346 KB)
    This pamphlet developed by Shriners Hospital for Children, also called Moving On, provides information for parents on letting go, assisting their young adults to become more independent, find health insurance, and transition to adult health care, as well as information on guardianship issues. It also offers a list of other resources and websites.

Physician Resources

  • Life Span Skills for Health (PDF Document 95 KB)
    For providers, this list includes skills that youth and young adults should develop as they change roles and take charge of their own healthcare, from understanding their condition to managing appointments and medications. From Healthy and Ready to Work.
  • Checklist for Transition (HRTW) (PDF Document 96 KB)
    A concise checklist (dated 2002 but still useful) for practices to review their transition system for young adults moving to adult care; Healthy & Ready to Work National Resource Center.
  • A Guide for Health Care Providers: Transition Planning for Adolescents with Special Health Care Needs and Disabilities
    Information and checklist for providers to help youth transition to adulthood. Includes the topics of health care, law, education, employment, recreation, and more. Companion manual for families and teens available; produced by the Institute for Community Inclusion at Children's Hospital, Boston 2000.
  • Transition Resources for Providers, University of Illinois
    Division of Specialized Care for Children (DSCC), from by the University of Illinois at Chicago. Includes general information for providers on transition from childhood to adulthood, including fact sheets, tools, transition timelines, and other materials.
  • Adolescent Health Transition Project (University of Washington)
    Resource for adolescents with special health care needs, chronic illnesses, and physical or developmental disabilities to understand the transitioning of healthcare and education to adulthood systems; Center on Human Development and Disability at the University of Washington.
  • Transition Coalition (University of Kansas)
    Free, online training for learning more about transition to adulthood, especially relevant for new care coordinators; University of Kansas, Department of Special Education.

Authors & Reviewers

Initial publication: December 2005; last update/revision: May 2019
Current Authors and Reviewers:
Contributing Author: Gina Pola-Money
Reviewer: Alfred N. Romeo, RN, PhD
Funding: Thank you to the Utah Medical Home Young Adult Advisory Committee for reviewing this section.
Authoring history
2005: first version: Robin PrattCA; Barbara Ward, RN BSCA; Joyce DolcourtCA; Kristine FergusonCA; Teresa Such-Neibar, DOCA; Lynn Foxx PeaseCA; Helen PostCA; Roz WelchCA
AAuthor; CAContributing Author; SASenior Author; RReviewer