Diabetes Initiative Logo  

Record of Grantee Meetings


Assessment Materials, Forms & Instruments


Participant Registration Form Spanish (PDF)

This one-page Spanish-language 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

Related Links

  • For other tools related to general program administration: Click here
  • For other tools on multiple self management behaviors: Click here
  • For other tools written in Spanish: 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.