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Record of Grantee Meetings
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Resources

Assessment Materials, Forms & Instruments

Summary

Patient Assessment Form (PDF)

This 11-page questionnaire was adapted from the Stanford Patient Education Research Center at Stanford University School of Medicine for use with the Help Yourself Chronic Disease Self Management Program at Marshall University. It is a comprehensive questionnaire that includes questions on participant background, general health, symptoms, physical activity, coping ability, feelings, and many more topics.

Author site: Dept. of Family and Comm. Health/Marshall University I 2004

Related Links

  • For other tools related to general program administration: Click here
  • For other tools on multiple self management behaviors: Click here
  • For more assessment tools: Go back

The Diabetes Initiative was a national program of the Robert Wood Johnson Foundation from 2002 to 2009.
Archived in 2009, this site is a repository for information and resources gathered over the course of the Initiative.
© 2002-2009 The Diabetes Initiative, a national program of the Robert Wood Johnson Foundation®
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