Information for Instructors

If you are an instructor starting a new class, please fill out your upcoming class information below. Updated versions of all data collection forms are at the bottom of the page.

New Falls Prevention Class Information

Fields marked with * are required

Please enter which days the program will take place each week
Please enter the start and end times of the program each week

Tai Ji Quan: Moving for Better Balance Instructor Forms

Please send Data Forms to:

Lillian Rozanski

Dartmouth Centers for Health and Aging

46 Centerra Parkway, Box 201

Lebanon, NH 03766

Cover Sheet and Instructions

 

UPDATED Attendance Log

 

UPDATED Participant Entry Form (Week 1)

 

Balance Screening Instructions

 

12 Week Screening Form

 

UPDATED Participant Post Program Survey (WEEK 24)

 

Matter of Balance Instructor Forms

Please send data forms to:

Sharon Feeney

Dartmouth Centers for Health and Aging

46 Centerra Parkway, Box 201

Lebanon, NH 03766

Cover Sheet and Instructions

 

UPDATED Matter of Balance Attendance Log

 

 

UPDATED Participant Entry Form

 

UPDATED Post Program Survey