Am I a Safe Driver?

Check the box if the statement applies to you.

check box I get lost while driving.
check box My friends and family members say they are worried about my driving.
check box Other cars seem to appear out of nowhere.
check box I have trouble seeing signs in time to respond to them.
check box Other drivers drive too fast.
check box Other drivers often honk at me.
check box Driving stresses me out.
check box After driving, I feel tired.
check box I have had more “near misses” lately.
check box Busy intersections bother me.
check box Left-hand turns make me nervous.
check box The glare from oncoming headlights bothers me.
check box My medication makes me dizzy or drowsy.
check box I have trouble turning the steering wheel.
check box I have trouble pushing down on the gas pedal or brakes.
check box I have trouble looking over my shoulder when I back up.
check box I have been stopped by the police for my driving recently.
check box People will no longer accept rides from me.
check box I don’t like to drive at night.
I have more trouble parking lately.

If you have checked any of the boxes, your safety may be at risk when you drive. Talk to your doctor about ways to improve your safety when you drive.


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