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National Council on Aging logo. We believe every person deserves to age well. That’s why we’re on a path to improve the lives of 40 million older adults by 2030.

Data Collection Tools for Falls Prevention Programs

Download the forms by language below. Each file is a zip folder with the following forms: 

  • Host Organization Information Form
  • Program Information Cover Sheet
  • Falls Prevention Program Group Leader/Coach Script
  • Attendance Log
  • Participant Information Form (Pre-Survey)
  • Post Session Survey
  • Optional Questions for Participant Pre- and Post- Surveys

Falls-Prevention-Data-Collection-Toolkit_2019

.pptx

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Falls Prevention Forms

Language (Format)Download
English (Word Documents)Link
English (Fillable PDFs)Link
Spanish (Word Documents)Link
Spanish (Fillable PDFs)Link
Arabic (Word Documents) Link
Armenian (Word Documents)Link
Gujarati (Word Documents)Link
Hindi (Word Documents)Link
Korean (Word Documents)Link
Mandarin (Word Documents)Link
Russian (Word Documents)Link
Urdu (Word Documents) Link

View Chronic Disease Self-Management Education Data Collection Tools.

The Healthy Aging Programs Integrated Database

Learn more about the Healthy Aging Program Integrated Database (HAPID®), a one-stop shop for all grantees and database users to enter workshop data and track performance for both falls prevention and CDSME evidence-based programs.  

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