Assessment Materials, Forms & Instruments
Participant Registration Form (PDF)
This one-page assessment tool is designed to be used by self management program staff to gather baseline information about patients or program participants. It includes questions about demographics, disease history and lifestyle behaviors such as exercise and smoking.
Author site: Gateway Community Health Center I 2003
- 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