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Assessment Materials, Forms & Instruments


Case Management Assessment and Follow Up Form (PDF)

This four-page assessment tool can be used for baseline assessment by case managers and other health professionals to learn information about patients that is essential to diabetes self management. The tool includes questions related to patient demographics and various topics including self management behaviors, depression and follow up.

Author site: Open Door Health Center I 2004

Related Links

  • 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

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.