Diabetes Initiative Logo  

Record of Grantee Meetings



Assessment Materials, Forms & Instruments


Patient Assessment Form (PDF)

This one-page assessment tool can be used as a quick form for patients to fill out about their self management activities and other health practices. One good use might be in an office waiting room or other similar settings.

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 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.