NC DAAS: Living Healthy Tools & Templates

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North Carolina Division of Aging and Adult Services

North Carolina's Initiative to Implement CDSMP

Tools & Templates

The following are some tools and templates that may be of help to you as you work to implement Living Healthy and Living Healthy with Diabetes. Some of the tools and templates were developed here in North Carolina—at the state, regional, county or local levels—while others were created in other states and shared among the national network of people and places implementing evidence-based health promotion and disease prevention programs for older adults.

Helpful Documents	Living Healthy Marketing Materials
CDSMP FAQ - All Key Skills – Things to Remember Living Healthy Adoption 101 Master Trainer Challenges & Solutions One Page CDSMP/DSMP Handout Region I’s Policies & Procedures Stanford Checklist for Program Coordinators Stanford Guidelines for Coordination Tips for Recruiting Participants Transporting Flipcharts & Materials Utilizing Volunteers Workshop Site Commitment Form Workshop Tracking Sheet for AAAs Class Roster and Emergency Contact List Participant Follow-up Form CDSMP Leader Assignment Form DSMP Leader Assignment Form Photo Release Form	Evidence-Based Programming Logo Flyer 1 (green) Template Flyer 2 (Man; It’s My Life) Template Living Healthy Talking Points Living Healthy Logo Sample Door Handle Sample Flyer - Lay Leader Training Sample Newspaper Ad Sample Newspaper Article Script for Recruiting Participants Slides & messages for a community presentation Testimonials – Lay Leaders Testimonials – Workshop Participants Tri-fold Brochure Template
Living Healthy Participant Workshop Documents and Materials	Living Healthy with Diabetes Marketing Materials
Class Roster/Emergency Contacts List Leader Assignment Form Folder Labels Key Points for Leaders to Remember Certificate of Completion 1 Certificate of Completion 2 Certificate of Completion 3	DSMP Lay Leader Certificate DSMP Participant Certificate DSMP Poster template DSMP Sample Flyer Flyer 1 template (“I have diabetes”) Living Healthy with Diabetes Logo One-page Information Sheet Reg F DSMP Brochure Reg F DSMP Poster Tri-fold Brochure Template
Data Collection Forms	Lay Leader Training Documents and Materials
Please note: Workshop leaders MUST have the 1st five documents listed below prior to the first session of their workshop. The 2nd, 3rd, and 5th documents are used to collect data and MUST be returned to the AAA Coordinator at the conclusion of the workshop. About the Workshop Data Packet Workshop Information Cover Sheet Workshop Attendance Log Welcome Letter for Participants Participant Information Survey Workshop Satisfaction Survey (optional)	Sample Lay Leader Position Description Sample Lay Leader Interview Form Sample Lay Leader Memo of Agreement Sample Lay Leader Certificate of Completion Lay Leader Training Checklist Sample Lay Leader Registration Lay Leader Training Attendance Sheet Lay Leader Information Form

Last updated August 26, 2011

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