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The purpose of this Assessment form

The purpose of this Assessment form is to ensure that both yourself as a candidate, and myself as your Driving Instructor, are fully informed of any health conditions or concerns you have regarding personal safety during driving lessons.

It is also to ensure any questions you have are answered and necessary planning and equipment are put in place before we commence all Driving Lessons.

If applicable, please take the time to discuss this form with your family members or those in your household before completing this form to ensure everyone in your home understands the questions and that your answers are accurate.

PLEASE NOTE:

YOU MUST NOTIFY ME IMMEDIATELY IF YOU OR ANY MEMBER OF YOUR IMMEDIATE HOUSEHOLD, SOCIAL CIRCLE OR WORK GROUP DEVELOP COVID-19 SYMPTOMS AND NEED TO SELF ISOLATE.

Visit here for advice on Covid 19 symptoms

You MUST NOT attend any driving lessons or tests if you have any Covid-19 symptoms

You WILL NOT BE CHARGED a short cancellation fee if the cancellation is due to Covid-19

The so-called "Freedom Day" arrived on 19th July 2021 but Covid is still floating around in the air we breathe and infecting in large numbers. Therefore, in accordance with guidance issued by the DVSA, this does not change anything with regard to Covid precautions. As the Instructor / Examiner are in an enclosed space with the Pupil / Candidate, masks MUST be worn and sanitiser used.


HEALTH




YES NO


YES NO


YES NO



PERSONAL PROTECTIVE EQUIPMENT (PPE)



NB If ‘YES’, you must bring your own products to clean your hands and keep you safe before touching the vehicle or controls in the car.

YES NO


YES NO


YES NO

CAR CLEANLINESS

I will be Sanitising the car between every lesson and before and after driving tests with anti-virus grade sanitiser. This means I will be wiping down all touchable surfaces with this sanitiser in spray and/or wipes form. Surfaces include, door frames, door handles inside and out, controls (signals, gear stick, parking brake, bonnet release), mirrors, seatbelts, seat adjusters and seats.



YES NO

CLOTHING AND FOOTWEAR

At time of writing (19th July 2021), it is a requirement that we wear suitable clothing and footwear. Footwear should be comfortable shoes or trainers (no open toed sandals). There may be a change to this policy, but this is the current guidance regarding clothing and footwear. May I please request that you ensure you comply with these requirements during your lesson and/or whilst out on your driving test.

Do you have any further questions? Please do not hesitate to ask.








Note : Personal information you submit on this form is not shared
or permenantly stored.


v 3.2
Lisa (SIDCUP)
Simon´s instruction was always clear, boosting my confidence, leaving me looking forward to my next lesson. I am over the moon passing first time with just 3 minors and will be going out on the ...
Lisa (SIDCUP)

CLEM (BEXLEY)
Simon made my learning experience safe, easy and enjoyable. I will definitely be continuing to my Pass Plus Course with Simon. Thank you.
CLEM (BEXLEY)





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