Ready Questionnaire (RSG)

The Ready Steady Go transition programme

The medical and nursing team aim to support you as you get older and help you gradually develop the confidence and skills to take charge of your own healthcare.

Filling in this questionnaire will help the team create a programme to suit you. Please answer all questions that are relevant to you and ask if you are unsure.

Email of your Doctor/Nurse/Healthcare professional

This will be used to send a copy of your questionnaire straight to your healthcare team. If you do not have this email address, use your own here and you will then receive a copy of the completed form to print out to take to your appointment

Name of your Consultant (if known)

Your Name

Date

Knowledge

Rows	Yes	I would like some help/advice with this	Comments
I can describe my condition
I know when to take my medications, names, doses, how often etc
I know who's who in the medical and nursing team
I understand the differences between children's and adult health care
I know about resources that offer support for young people with my condition

Self Advocacy (Speaking up for yourself

Rows	Yes	I would like some help/advice with this	Comments
I feel ready to start preparing to be seen alone for part of the clinic visit in the future
I ask my own questions in clinic
I have heard and know about 'Ask 3 Questions'

Health and Lifestyle

Rows	Yes	I would like some help/advice with this	Comments
I understand it is important to exercise for my general health and condition
I ask my own questions in clinic
I have heard and know about 'Ask 3 Questions'

Health and Lifestyle

Rows	Yes	I would like some help/advice with this	Comments
I understand it is important to exercise for my general health and condition
I understand the risks of alcohol, drugs and smoking to my health
I understand what appropriate eating means for my general health
I am aware that my condition can affect how I develop e.g puberty
I know where and how I can access reliable information about sexual health

Daily Living

Rows	Yes	I would like some help/advice with this	Comments
I can look after myself at home in terms of dressing/showering etc
I can make my own snacks/meals
I am able to be away from home overnight

School and Your Future

Rows	Yes	I would like some help/advice with this	Comments
I am managing at school e.g getting to and around school, school work, PE, friends etc
I know what I want to do when I leave school

Leisure

Rows	Yes	I would like some help/advice with this	Comments
I can use public transport and access my local community e.g shops, leisure centre, cinema
I see my friends outside school

Managing your Emotions

Rows	Yes	I would like some help/advice with this	Comments
I know how to deal with unwelcome comments/bullying
I know someone I can talk to when I feel sad/fed-up
I know how to deal with emotions such as anger or anxiety
I am comfortable with the way I look
I am happy with life

Transfer to Adult Care

Rows	Yes	I would like some help/advice with this	Comments
I understand the meaning of 'transition' and transfer of information about me

Please list anything else you would like help or advice with

The Ready Steady Go transition programme - Getting Ready