Program Planning and Data Collection Forms

Data Requirements

PEMS Data Variables - 2008

Required Data Variables Dashboard

Intervention-Specific Data Variable Requirements

Updated CDC Forms (all required data variables):

Aggregate Forms:

• Aggregate  - Health Education/Risk Reduction (HE/RR)
• Aggregate - Health Communication/Public Information (HC/PI)

Client Forms (Enrollment/Recruitment)

• Client Data Collection Form (Client Administered)

• Client Data Collection Form (Provided Administered/Data Entry format)

Session & HE/RR Data Collection Forms:

• Session Information/Activity Form

• Group Level Intervention (GLI) Form

Older Forms Below - if you use this forms, please make you are collecting all required data variables. If you have questions, regarding the required data variables please contact your contract monitor.