When writing IEP's I like to have as much student input as possible. This survey has helped me to develop my PLEPS, goals, and program modifications. The questions aim to have the student reflect the past year and establish goals for the upcoming one.
I originally designed this tool to prepare students to speak at their own annual review. In many districts, students are invited to their meetings and encouraged to advocate for themselves. I used this sheet to prepare them and give them a couple of talking points.