Sample intake for Maya Rivera

This is what the guided transition-planning interview looks like once a family or educator finishes. We use this to draft the Pathway Report on the next screen.

Who's Filling This Out

Section 1 of 5

Role We tailor the report's language to who is reading it.: Family member (parent or caregiver)
Student's first name: Maya
Grade band: 11th–12th grade

Strengths & Interests

Section 2 of 5

What is the student good at? Specific, observable strengths anchor the whole report.: Patient and gentle with animals — walks the family dog every morning. Detailed observer (notices things others miss). Strong visual memory; can recreate drawings from memory. Reliable when routines are clear and expectations are written down.
What does the student enjoy?: Animals (especially dogs and birds), drawing and digital art, environmental clean-ups, baking, watching nature documentaries, organizing her bookshelf by color.

Needs & Supports

Section 3 of 5

Disability-related needs: Sensory sensitivity to loud, unpredictable noise (cafeteria, fire drills). Needs extra processing time for verbal instructions. Anxiety in new social situations. Benefits from written checklists and a quiet break space.
Supports that work We use these to recommend realistic accommodations for each pathway.: Visual schedules, written step-by-step directions, 1:1 check-ins at the start of class, advance notice of changes, noise-reducing headphones, small-group instruction.
Transportation: Currently rides the school bus. Has not started driver's ed. Family is open to public transit training through the school.
Communication: Verbal but quiet. Prefers texting over calls. Will advocate for herself once she knows it's safe — needs a trusted adult to open the door.

Current Goals & Concerns

Section 4 of 5

Current IEP transition goals We translate these into plain English in the report.: Maya will increase self-advocacy by independently requesting accommodations in 4 of 5 opportunities. Maya will identify 3 postsecondary career interests and complete a job-shadow experience by end of 11th grade.
Family concerns: Worried about life after high school — whether Maya can hold a job, manage money, and live semi-independently. Want her to find work she actually enjoys, not just any job. Need help understanding adult services (BRS, DDS).

The Three Voices

Section 5 of 5

In the student's own words Student voice carries the most weight in our recommendations.: I want to work with animals. Maybe a vet office or a shelter. I don't want to go to a big college but I'd try community college if it's not too loud. I want my own apartment someday with a cat.
From the family: We want Maya to feel proud of what she can do. We need a plan that builds her independence step by step — not all at once. We also want to know what supports are available after she ages out at 22.
From the educator / case manager: Maya is making strong gains in self-advocacy this year. She volunteered at the school food pantry and was reliable every week. She struggles with unstructured time and benefits from job-embedded learning. Recommend exploring CT BRS pre-employment transition services this spring.

Walking with Maya · Step 2 of 6

Student Hub Pathway Report