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 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
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:
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
Session 1 Handouts for Participants
(One form per participant)
Welcome Letter Coming Soon!
Workshop Overview and Homework by Session
Last Session Forms
Option 1:
*AgeOptions Facilitators- Use the following survey: English
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 on the ILPTH participant portal (These are the same instructions that are available above for completing Session 1 forms)
Links and Other Materials
Individual forms included in Participant Registration Packet- Registration Form, Privacy Policy, and Liability Waiver
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
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
ILPTH Evidence Based Program Flyer
Take Charge Series Program Flyer
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.