An initiative of The N.C. Center for Health & Wellness at UNC Asheville | Statement of Compassion & Inclusion

Program Forms

Reports generated from data collection are valuable for everyone —  participants, community sites, funders and policymakers.
These reports are helping the evidence-based movement not only locally in your own communities, but nationally.
The forms below can be completed as a fillable PDF or they can be printed out to serve either virtual or in-person workshops.
Please contact healthyagingncinfo@gmail.com if you have any questions about the forms.

Download and share the one-pager:  Using Fillable Portable Document Files for Survey Data Collection

A Matter of Balance
Participant Agreement Par Q Fillable
AMOB Program Info Cover Sheet Fillable  (7/29/21)
AMOB Attendance with TUG Fillable    (7/29/21)
AMOB Participant Info Form / First Session Survey Fillable    (7/29/21)
AMOB Post Session Survey Fillable    (7/29/21)

Tai Chi for Arthritis and Fall Prevention 
TCA/FP Registration Form Fillable
Participant Agreement Par Q Fillable
TCAFP Program Info Cover Sheet Fillable    (7/29/21)
TCAFP Attendance for Virtual Fillable with Totals  (7/29/21)
TCAFP Participant Info Form / First Session Survey Fillable   (7/29/21)
TCAFP Post Session Survey Fillable    (7/29/21)

Walk With Ease
WWE Participant Information Form Fillable
WWE Attendance Log Fillable
WWE Post Program Form Fillable
WWE Fidelity Evaluation Checklist Form Fillable

Chronic Disease Self-Management Education (CDSME) Programs
CDSME Cover Sheet Fillable Fields
CDSME Attendance Log Fillable Fields
CDSME Participant Pre-Survey Fillable Fields
CDSME Participant Post-Survey Fillable Fields
Tipsheet for Collecting Data

CDSME Forms Instruction Webinar