Key Takeaways
Organizations funded by the Administration for Community Living are required to collect data on evidence-based chronic disease self-management education workshops.
The forms have been translated into the most common languages used for workshop implementation. Contact us if you don't see the language you need.
Download the forms by language below. Each file is a zip folder with the following forms:
- Host/Implementation Organization Information Form
- Program Information Cover Sheet
- Attendance Log
- Participant Information Survey
- Group Leader Script
English (Word documents)
CDSME-Forms-English
English (Fillable PDFs)
CDSME_Fillable_Forms
Arabic (Word documents)
CDSME%20Arabic%207
Cantonese (Word documents)
CDSME-Forms-Cantonese
Guajarati (Word documents)
CDSME%20Gujarati%207
Hindi (Word documents)
CDSME%20Hindi%207
Hmong (Word documents)
CDSME-Forms-Hmong
Korean (Word documents)
CDSME-Forms-Korean
Lao (Word documents)
CDSME-Forms-Lao
Mandarin (Word documents)
CDSME-Forms-Mandarin
Portuguese (Word documents)
CDSME-Forms-Portuguese
Somali (Word documents)
CDSME-Forms-Somali
Spanish (Word Documents)
CDSME-Forms-Spanish
Spanish (Fillable PDFs)
CDSME_Forms_Spanish_Fillable_PDFs
Tongan (Word documents)
CDSME-Forms-Tongan
Urdu (Word documents)
CDSME%20Urdu%207
Vietnamese (Word documents)
