WISEWOMAN

Updated Forms for FY22

• WISEWOMAN FY22 Calendar of Events 
• WISEWOMAN FY22 Service Area Map 
• WISEWOMAN FY22 Cardiovascular Screening Guidelines 
• WISEWOMAN Service Delivery Flow Chart 

WISEWOMAN Program Manuals

Cardiovascular Screening Information Manual for Local Program Coordinators

• WISEWOMAN Coordinator Manual  
• WISEWOMAN MTM Pharmacist Manual 
• Health Care Provider Manual 

Updated Consent Forms 

• WISEWOMAN Verbal Consent Form 
• WISEWOMAN Walk With Ease Consent Form 

Data Collection Forms 

• WISEWOMAN Consent Form 
• Revised Health Risk Assessment - Page 1 
• Revised Health Risk Assessment - Page 2
• Revised Health Risk Assessment-Page 3   
• Revised Health Coaching Form-Page 1
• Revised Health Coaching Form -Page 2
• Revised Health Coaching Form-Page 3 
• Health Coaching Post Evaluation Form-Page 1 
• Health Coaching Post Evaluation Form-Page 2 
• Laboratory Assessment 
• Cardiovascular Disease Follow-Up
• Revised CVD Evaluation Form
• Updated Vouching Criteria 

Data Forms in Spanish 

• WISEWOMAN Spanish Consent Form 
• Revised Spanish Health Risk Assessment-Page 1
• Revised Spanish Health Risk Assessment -Page 2
• Revised Spanish Health Risk Assessment -Page 3 

Other WISEWOMAN Forms

• WISEWOMAN Master Form
• WISEWOMAN Order Form   
• Refusal of Care Follow-Up Form - WISEWOMAN Services- If you need access to the "Refusal of Care - Follow-Up Form" for WISEWOMAN screening services, please contact Sonya Loynachan. Sonya can be reached at Sonya.Loynachan@idph.iowa.gov or 515-725-0693.

 Recorded Webinars and Trainings 

• Recording of Annual Meeting on October 13, 2021
• Slides from Annual Meeting on October 13, 2021 
• Recording of Spring Meeting on May 19, 2021
• Slides from Spring Meeting on May 19, 2021 
• Recording of Post Evaluation Health Coaching Session on February 11, 2021
• Slides from training on How Dental Disease Impacts the Body on February 4, 2021 
• Recording from training on How Dental Disease Impacts the Body on February 4, 2021 
• Motivational Interviewing Refresher Webinar on April 23, 2020
• Cultural Relativity Training Webinar on February 10, 2020
• Slides from Cultural Relativity Training Webinar  
• Evaluation and Consent Form Training on February 6, 2020
• Slides from Follow-up Screening Visit Webinar on September 23, 2019 
• Recording from Follow-up Visit Webinar on September 23, 2019- To be posted soon
• Health Coaching Form Training Webinar held on March 19, 2019
• SafeNetRx Webinar held on March 13, 2019
• Dummy Screening Form Training Webinar held on March 4, 2019
• Vouching Training Webinar held on February 13, 2019

Local Program Letters

• Introduction Letter (Palo Alto Program)
• Standard Letter with Results (Black Hawk Program)
• Standard Letter after Phone Contact- Activity and Nutrition Focus (Black Hawk Program)
• Standard Letter after Phone Contact- Nutrition Focus (Black Hawk Program)