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 Checklist- For all Take Charge Programs. Instructions for data collection from registration to last session

Attendance Sheet- Excel Document

Attendance Sheet- Printable Form

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

Session 1 Virtual Data Collection Script- To 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 Guide- Instructions 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 Guide- Instructions 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)