An initiative of The N.C. Center for Health & Wellness at UNC Asheville

Program Forms

Walk with Ease Paperwork

OsteoArthritis Action Alliance (OAAA) Walk With Ease Data Collection Packet

WWE Participant Information Form  (updated 1/15/2019)

WWE Attendance Log  (updated 11/8/18)

 WWE Participant Post Program Form   (updated 1/15/2019)

Fidelity Evaluation Checklist

Image result for walk with ease logo


Updated paperwork for Living Healthy with CDSME workshops

The following forms are required for all CDSME workshops (Program Information Cover Sheet, Attendance Log, and Participant Information Survey):

Program Information Cover Sheet

Attendance Log

Participant Information Survey    (updated 11/8/18)

Tipsheet for Collecting Data

Spanish CDSME Participant Info Survey    (updated 11/29/18)

Spanish Program Info Cover Sheet

Spanish CDSME Attendance Log

Reminder:  If you are in one of the WNC regions (A,B,C,D,E) participating in the Mission Health Partners falls prevention referral pathway, please contact us for the appropriate survey forms.

A Matter of Balance Data Collection Forms

AMOB First Session Survey    (updated 11/13/18) A Matter of Balance Logo

AMOB Last Session Survey    (updated 11/13/18)

AMOB Class Info Sheet

AMOB Attendance Sheet

Participant Agreement and Par Q


Tai Chi for Arthritis and Falls Prevention Data Collection Forms

Tai Chi First Session Survey   (updated 11/13/18)

Tai Chi Last Session Survey   (updated 11/13/18) 

Tai Chi Class Info Cover Sheet

Tai Chi Attendance Sheet 20 hrs

Participant Agreement and Par Q