Bingocize Leader Resources
Update on Fall Prevention Program Funding and Reporting
The 2019 Administration for Community Living (ACL) grant to the Illinois Pathways to Health (ILPTH) Initiative has concluded.
If you are facilitating fall prevention workshops under other current funding received from AgeOptions, please continue to register your workshops and submit participant data through the ILPTH website.
If you are not currently funded by AgeOptions but continue to offer fall prevention workshops, we still strongly encourage you to register your workshops and submit participant data and pre/post surveys.
Doing so benefits everyone involved:
- Increased visibility: AgeOptions has invested in media campaigns—including commercials, banner ads, redirecting, and geofencing—to raise public awareness of ILPTH workshops and enhance your organization’s visibility.
- Leader support: We monitor leader certifications and will notify you when renewal is needed.
- Access to technical assistance: Ongoing support from AgeOptions is available for your workshops.
- Data Reports: You can receive access to both workshop-level data and participant survey reports.
- Support for future funding: Data collection strengthens AgeOptions' proposals for continued statewide health promotion funding.
If you would like to submit participant data but will not be entering it directly into ILPTH, email forms to joan.fox@ageoptions.org.
Data Collection Checklist- Instructions for data collection from registration to last session
Attendance Sheet- Use to track participant attendance.
Participant Form Tracker- Use to track participant forms received. Please use if sending data to AgeOptions for data entry.
Participant Sign-In Sheet- Leaders can have participants use to sign-in. Not required.
Session 1 Data Collection Script- To be read aloud to participants during Session 1 English - Spanish
Session 1 Virtual Data Collection Script- To be read aloud to participants during Session 1 English - Spanish
Photo Media Release- This form is optional; to be used if collecting testimonials or taking pictures. Feel free to edit to add your organization's information English - Spanish
Falls Prevention Leader Packet
Forms for Participants
Participants can choose one of the following options when completing paperwork:
- Complete a paper form or fillable PDF
- Receive a link to complete an electronic form (through Microsoft Forms)
- Register for a participant portal on the IL Pathways website and complete forms directly in the portal (The surveys through the portal are available in English only. Spanish participants can complete through the portal if their computer is set up to translate the page to Spanish)
Note: If you choose to you use Microsoft Forms, the surveys are submitted directly to AgeOptions. AgeOptions will complete the data entry.
Session 1 Participant Registration Forms and Pre-Survey
Option 1:
- Printable/Fillable Participant Registration Packet- English - Spanish
- Printable/Fillable Participant Pre-Survey- English - Spanish
Option 2:
- Link to Electronic Participant Registration Packet and Pre-Survey- Email us at info@ilpathwaystohealth.org to request a survey link for your specific workshop
Option 3:
- Participant Guide for ILPTH Portal- Instructions that can be sent to participants for completing electronic forms on the ILPTH participant portal
Note for Spanish participants: The surveys on the portal are in English only, unless the participant has a computer that is already set up to translate the page to Spanish.
Session 1 Handouts for Participants
(One form per participant)
Welcome Letter- The welcome letter provides an intro to the program and the forms that participants will receive. The letter can be mailed to participants with workshop forms for online workshops- English - Spanish
Falls Prevention Participant Packet
Falls Prevention Take Home Cards
Last Session Forms
Option 1:
Option 2:
- Link to Electronic Participant Post-Survey- Email us at info@ilpathwaystohealth.org to request a survey link for your specific workshop.
Option 3:
- Participant Guide for ILPTH Portal- Instructions that can be sent to participants for completing electronic forms (These are the same instructions that are available above for completing Session 1 forms)
Note for Spanish participants: The surveys on the portal are in English only, unless the participant has a computer that is already set up to translate the page to Spanish
Links and Other Materials
Email Templates- For leaders to send to participants for online workshops English - Spanish
Zoom Instructions- For online workshops English - Spanish
Marketing Materials
ILPTH Evidence Based Program Flyer
Home Safety Checklist- Feel free to update the flyer with your organization's logo English - Spanish
ILPTH Outreach Toolkit Template- This Toolkit includes templates for flyers, posters, social media posts, etc. You will need to have a Canva account to access the template and create a COPY to make edits (DO NOT EDIT THE TEMPLATE). If you need help doing so, please refer to our ILPTH Outreach Toolkit User Guide.