Reports generated from data collection are valuable for everyone — participants, community sites, funders and policymakers.
These reports are helping the evidence-based movement not only locally in your own communities, but nationally.
Mon Ami
Please use workshop forms in the Mon Ami system. The links below are for reference only (not for data collection). Please contact healthyagingncinfo@gmail.com if you have any questions about the forms or the Mon Ami system.
A Matter of Balance
Mon Ami Forms
The following 3 forms will be entered into Mon Ami. Please note that the PAR-Q form has been changed to the Virtual Program Registration Form.
AMOB Participant Info Form / First Session Survey (PDF Fillable)
AMOB Post Session Survey (PDF Fillable)
AMOB Virtual Program Registration Form (PDF Fillable) – Please note that this form is required to be entered into Mon Ami if your AMOB workshop is delivered virtually. You are still welcome and encouraged to distribute this form to your participants, as it contains safety and emergency contact information.
Additional Forms
AMOB Program Info Cover Sheet (PDF Fillable)
AMOB Attendance with TUG (PDF Fillable)
AMOB Fidelity Checklist
Tai Chi for Arthritis and Fall Prevention
Mon Ami Forms
The following 3 forms will be entered into Mon Ami. Please note that the TCA/FP Registration Form and the PAR-Q form have been combined into the Virtual Program Registration Form.
TCAFP Participant Info Form / First Session Survey (PDF Fillable)
TCAFP Post Session Survey (PDF Fillable)
TCAFP Virtual Program Registration Form (PDF Fillable) – Please note that this form is required to be entered into Mon Ami if your TCAFP workshop is delivered virtually. You are still welcome and encouraged to distribute this form to your participants, as it contains safety and emergency contact information.
Additional Forms
TCA/FP Program Info Cover Sheet (PDF Fillable)
16 Session TCAFP Attendance for Virtual Fillable with Totals
TCAFP Fidelity Checklist
Tai Chi 60 Day Challenge
Use the daily practice log below for the Tai Chi 60 Day Challenge! After you reach 60 days of practice, submit your completed log to Nicole Hiegl, TCHI Senior Trainer, and you will receive a certificate of completion and a TCHI patch to honor your commitment to yourself.
Walk With Ease
Mon Ami Forms
The following Pre/Post survey forms will be entered in Mon Ami.
WWE Participant Information Form (Pre-Survey) (PDF Fillable)
WWE Post Program Form (PDF Fillable)
Additional Forms
WWE Attendance Log (PDF Fillable)
WWE Fidelity Evaluation Checklist (PDF Fillable)
Chronic Disease Self-Management Education (CDSME) Programs
Attention All Chronic Disease Program Providers:
NEW 2023 fillable CDSME program forms are HERE! See links below. AND the new CDSME forms have been uploaded to the Mon Ami database for partners to complete their workshop data entry process. All previous versions of CDSME forms are no longer valid as of August 31, 2023.
Mon Ami Forms
CDSME Participant Pre- and Post-Survey Set (PDF Fillable) – This document contains both pre- and post-surveys
CDSME Emergency Contact Form – This form is to be completed and entered in Mon Ami for virtually delivered workshops.
Additional Forms
CDSME Cover Sheet with Fillable Fields (top line/blank for program name)
CDSME Attendance Log with Fillable Fields (top line/blank for program name)
Tipsheet for Collecting Data
CDSME Fidelity Checklist
EnhanceFitness
Mon Ami Forms
EF Participant Information Form (Pre-Survey) (PDF Fillable)
EF Post Program Form (PDF Fillable)
Health Coaching
Once assigned to a health coach, all forms will be administered through the Healthie Platform.