Download Clinical Measures and Followup Form
FOR INTERNAL USE ONLY (For Strategy 3)
Participant identification (ID) number:
Name of person completing the form:
Community Health Worker identification (ID) number:
Project Location: Clinic
Information on this page is taken from the English print version of “Healthy Heart, Healthy Family: A Community Health Worker's Manual.” U.S. Department of Health and Human Services, National Institutes of Health, National Heart Lung and Blood Institute, NIH Publication No. 08-3674, Originally Printed 1999, Revised May 2008.
Last Updated March 2012