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PPHF – 2012 - Empowering Older Adults and Adults with Disabilities through Chronic Disease Self-Management Education (CDSME) Programs financed by 2012 Prevention and Public Health Funds (PPHF-2012)


List of Standardized Data Collection Tools


Type of Respondent Form Name Frequency of Response
State Government Attachment D: CDSME Semi-annual Program Progress Report Twice a year
Attachment G: Integrated Services Delivery System Assessment Tool Once annually
Local staff and volunteers (collection of data and data entry) Attachment A: Workshop Information Cover Sheet/ Attachment B: Participant Information Survey/ Attachment C: Attendance Log Once per workshop
Attachment F: Organization Data Form Once whenever a new site is added
Workshop Participants Attachment B: Participant Information Survey Once


Last Modified: 6/28/2012 10:20:09 AM