Take Charge Programs Leader Resources

Includes workshop material for:

  • Take Charge of Your Health (CDSMP)
  • Take Charge of Your Diabetes (DSMP)
  • Take Charge of Your Pain
  • Cancer: Thriving and Surviving
  • Workplace CDSMP

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

Download document Data Collection ChecklistFor all Take Charge Programs

Download document Attendance SheetExcel Document

Download document Attendance Sheet- Printable Form

Download document Session 1 Data Collection Script

Download document Session 1 Virtual Data Collection Script

 


Fillable Forms for Participants

One form per participant, unless participant will be using electronic forms

Session 1

Download document Participant Registration Packet- Includes registration form, privacy policy, and liability waiver 

Download document Welcome Letter: CDSMP - DSMP - PAIN - CANCER - Workplace CDSMP

Download document Workshop Overview and Homework by Session: CDSMP - DSMP - PAIN - CANCER - Workplace CDSMP

Download documentMenu Planning 1For Take Charge of Your Diabetes only

Download documentMenu Planning 2For Take Charge of Your Diabetes only

Download document Pain/ Mood DiaryFor Workplace CDSMP only

Download documentTime Management Worksheet- For Workplace CDSMP only

Download document Participant Pre-Survey

Last Session

Download document Participant Post-Survey

Optional

Download document Photo Media Release- Feel free to edit to add your organization's information

Download document Zoom Instructions- (Provided by Rush) For online workshops

Download document Participant Certificate of Completion Template

 


Electronic Forms for Participants

Electronic forms are available through the ILPTH Participant Portal

Download document Participant GuideInstructions that can be sent to participants for completing electronic surveys

 


Links and Other Materials:

Download document Workshop 101

Download document Pre-workshop Checklist and Participant Recruitment Plan

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

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

Download document Fidelity Visit Checklist

Download document 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:

Download document IL Pathways to Health Logo

Download document ILPTH Evidence Based Program Flyer