Workplace CDSMP Leader Resources

Upon workshop completion, email attendance sheet to joan.fox@ageoptions.org

If you will NOT be entering class participant data, and participants are NOT using electronic forms, email the completed participant forms to joan.fox@ageotions.org


Course Materials for Leaders

Data Collection ChecklistFor all Take Charge Programs. Instructions for data collection from registration to last session

Attendance SheetExcel Document

Attendance Sheet- Printable Form

Session 1 Data Collection Script- To be read aloud to participants during Session 1

Session 1 Virtual Data Collection ScriptTo be read aloud to participants during Session 1

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

 


Forms for Participants

Participants can choose one of the following options when completing paperwork:

  • Complete a paper form
  • Receive a link for a 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

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 and 2:

Printable/Fillable PDF Participant Registration Packet- Includes registration form, privacy policy, and liability waiver 

Printable/Fillable Participant Pre-Survey 

Option 3:

Link to Electronic Participant Registration Packet and Pre-Survey- https://forms.office.com/r/Axne6YXuWt

Option 4:

Participant GuideInstructions that can be sent to participants for completing electronic forms on the ILPTH participant portal

Session 1 Handouts for Participants

(One form per participant)

Welcome Letter  Coming Soon!

Workshop Overview and Homework by Session

Pain/ Mood Diary

Time Management Worksheet

Last Session Forms

Option 1 and 2:

Printable/Fillable Participant Post-Survey

Option 3:

Link to Electronic Participant Post-Survey- https://forms.office.com/r/NzjsJLMabr

Option 4:

Participant GuideInstructions that can be sent to participants for completing electronic forms on the ILPTH participant portal (These are the same instructions that are available above for completing Session 1 forms)

 


Links and Other Materials

Workshop 101

Pre-workshop Checklist and Participant Recruitment Plan

Email Templates- For leaders to send to participants for online workshops

Zoom Instructions- (Provided by Rush) For online workshops

Participant Certificate of Completion Template

Crisis Intervention Plan- Provides general guidance about what to do in crisis situations

Fidelity Visit Checklist

Receipt Template for Books/CD's

Brief Body Scan- Contact us if you would like to purchase a CD. You may also Google or use YouTube to find a meditation.

 


Marketing Materials

IL Pathways to Health Logo

ILPTH Evidence Based Program Flyer