Individual Travel Assessment Worksheet
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1INDIVIDUAL TRAVEL ASSESSMENT WORKSHEET
This individual travel assessment is designed for use when TRiPS is not available. Soldiers should complete
this worksheet and discuss with their leaders prior to travel in order to mitigate risk.
PRE-TRIP CHECKLIST FOR LEADERS
Discuss Hazards, Risk, &
Use this checklist when trips are planned. Apply risk management controls if
Controls
needed. Identify hazards, risk, and controls in right column.
Point of Origin to Destination
Point of origin_____________________________________________________
Destination_______________________________________________________
Planned rest stops/breaks_____________________________________________
Anticipated weather conditions_________________________________________
Travel distance one way____________________________________________
Mode of travel____________________________________________________
If driving POV: # of licensed drivers___________________________________
Name______________________________Unit____________________
Name______________________________Unit____________________
Name______________________________Unit____________________
Will you wear your seatbelt at all times? _______________________________
How much sleep will you have in the 12 hrs prior to starting your trip? ________
Are you currently taking any over-the-counter or prescribed medications?_____
Have you checked to make sure the medication will not affect driving?________
Hotel
Will the majority of your trip take place during day or night?_________________
Name______________________
Planned rest stops/breaks___________________________________________
City________________________
Point of origin departure date and time_________________________________
Date Check-In________________
Expected destination arrival time______________________________________
Return from Destination to Point of Origin
Mode of travel____________________________________________________
Planned rest stops/breaks____________________________________________
Anticipated weather conditions_________________________________________
If driving POV: # of licensed drivers___________________________________
Name______________________________Unit____________________
Name______________________________Unit____________________
Name______________________________Unit____________________
Hotel
Will you wear your seatbelt at all times? ________________________________
Name______________________
How much sleep will you have in the 12 hrs prior to starting your trip? ________
City________________________
Will the majority of your trip take place during day or night?_________________
Destination departure date and time___________________________________
Date Check-In________________
Expected arrival time at point of origin__________________________________
Yes
No
VEHICLE CONDITION: OLD
NEW
Vehicle Inspected?
Yes
No
INSURANCE: Is Soldier's car insurance coverage up to date/current?
Yes
No
DRIVER'S LICENSE: Does Soldier possess a valid driver's license?
SIGNATURES
Soldier Planning Trip:
Name/Rank/Signature:_________________________
DATE_______________
Supervisor:
Name/Rank/Signature:_________________________
DATE_______________
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