Assessment Materials, Forms & Instruments
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
- For other tools related to general program administration: Click here
- For other tools on multiple self management behaviors: Click here
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