Downloadable Forms

We encourage you to use these forms as needed and change them as needed to reflect your congregation. We ask that in any use of this material you reference the CHAMPS office.

The Emergency Contact Card is a tool for keeping contact information on family members or friends to be notified in the event of an emergency when members are present at worship or a church function. The intent of this card is strictly for emergency contact purposes and was not intended to include medical information. These cards can be updated annually or as appropriate. Emergency Contact Card

The Assessment tools can be used as a guide to develop programming and events that will best fulfill the needs of your congregation. These assessments can be changed to meet the wishes of your congregation. Assessment Tool #1 - Assessment Tool #2 - Assessment Tool #3

The form Charting Our Progress is a tool than can be used to track the programming and events already in place and to identify needs for future development to promote healthy aging across the life span. An example of existing CHAMPS programming is attached as a guide in using this form. Charting Our Progress - CHAMPS Example

The Medical Information Sheet/Liability Release and Pre-Exercise Program Readiness Questionnaire should be completed prior to beginning a physical activity class of any kind. This form can be altered to reflect your congregation's needs. Pre-Exercise Program Readiness Questionnaire - Medical Information Sheet & Liability Release

The Initial Contact Sheet has been designed for use by a professional nurse as a means of assessing an individual's needs. This form can be altered to reflect the needs of your congregation. Initial Contact Sheet