Organizations funded by the Administration for Community Living are required to collect data on evidence-based falls prevention programs.
Please find the necessary data paperwork below, and please reach out to fallsfree@Stonybrookmedicine.edu with any questions.
1. Host/Implementation Organization Information Form
2. Program Information Cover Sheet
3. Participant Information Form (Pre-Survey)
4. Post-Survey
A Matter of Balance:
A Matter of Balance – Attendance Sheet
A Matter of Balance – Data Collection Tips
Tai Chi for Arthritis and Falls Prevention:
Tai Chi for Arthritis – Attendance Sheet
Tai Chi for Arthritis – Data Collection Tips
Stepping On:
Stepping On – Attendance Sheet
Stepping On – Data Collection Tips
Otago Exercise Program:
Otago Exercise Program (Group Class) – Attendance Sheet
Otago Exercise Program – assessment tracking (Session 0)
Otago Exercise Program – Data Collection Tips for Group Classes
*For 1:1 Otago Exercise Program documents please reach out to fallsfree@stonybrookmedicine.edu
For copies in languages other than English please visit NCOA’s Website.