The purpose of this page is to provide you with the most updated version of data collection forms and sample evaluations. The first section contains documents for your general information. The remaining sections contain forms organized in the three overarching categories of AHEC programming: Health Careers Promotion, Community-based Student Education, and Continuing Education.

Below are the revised A-TrACC data collection forms (Word Documents) for the 2013-2014 program year. Please note: The program year is from July 1st to June 30th. The AHEC Training and Consultation Center (A-TrACC) maintains an archive of their recorded trainings arranged by topic on the HRSA website.  The archived traninings can be accessed via the link listed below.

• A-TrACC Field Guide Forms (updated 2013-2014)
• A-TrACC Archived Trainings

PDF FORMS

Below are the printable PDF versions of the HCPP forms. You can use these forms to capture information in person from your participants. Each form will open in a new window.

• HCPP Participant Profile Form
• HCPP Activity Form
• Health Education Activity Form

HCPP FORM - NEW

Below is the new HCPP data collection form. Use this form to caputre data for health career promotion programs, activities and participants beginning with the 2013-2014 program year. The Word document contains all the forms used for capturing HCPP data.  Note: the numbers on the Word forms correspond to fields within the spreadsheet.

• HCPP FieldGuide Spreadsheet

HCPP SPREADSHEET - NEW

Below is the new HCPP spreadsheet. Use this spreadsheet to caputre health careers promotion data beginning with the 2013-2014 program year. The spreadsheet contains mulitple tabs which capture all of the data for HCPP programs and participants. Note: the numbers on the Word forms correspond to fields within the spreadsheet.

• HCPP FieldGuide Spreadsheet

WEB FORMS

Below are the links to the web-based HCPP forms. The information entered into these forms go directly into the AHEC database. Access these links to enter data for quarterly report submissions.The pages will open in a new window.

• HCPP Participant Profile Form
• HCPP Activity Form (For AHEC Center data submission only)
• HCPP Health Education Activity Form (For AHEC Center data submission only)

PDF FORMS

Below are the printable PDF versions of the CBSE forms. You can use the profile form to capture information in person from your participants. The CBSE Site Form and CBSE Rotation Form are for AHEC use only. Each form will open in a new window.

• CBSE Participant Profile
• CBSE Site Form (For AHEC Center data submission only)

CBSE FORMS - NEW

Below is the new CBSE data collection form. Use this form to caputre data for students and sites participating in clinical rotations beginning with the 2013-2014 program year. The Word document contains all the forms used for capturing CBSE data.  Note: the numbers on the Word forms correspond to fields within the spreadsheet.

• CBSE Field Guide Forms

CBSE SPREADSHEET - NEW

Below is the new CBSE spreadsheet.  Use this spreadsheet to capture clinical rotation and individual level health professions student data beginning with the 2013-2014 program year. The spreadsheet contains mulitple tabs which capture all of the data for CBSE programs and participants. Note: the numbers on the Word forms correspond to fields within the spreadsheet.

• CBSE Field Guide Spreadsheet

WEB FORMS

Below are the links to the web-based CBSE forms. The information entered into these forms go directly into the AHEC database. Access these links to enter data for quarterly report submissions. The pages will open in a new window.

• CBSE Participant Profile Form
• CBSE Site Form (For AHEC Center data submission only)

PDF FORMS

Below are the PDF versions of the CE forms. You can use these forms to capture information in person from your participants. You can also email the forms as an attachment. When participants submit the information it will upload to the AHEC database (unless otherwise requested). Each document will open in a new window.

• CE Participant Registration
• CE Sample Evaluation (Use this form to develop your CE evaluation)
• CE Report Form (For AHEC Center data submission only)

CE FORMS - NEW

Below are the new CE data collection forms. Use these forms to caputre continuing education program data beginning with the 2013-2014 program year. The Word document contains all the forms used for capturing CE data at a program and individial level. Note: the numbers on the Word forms correspond to fields within the spreadsheet.

• CE Field Guide Forms

CE SPREADSHEET - NEW

Below is the new CE spreadsheet. Use this spreadsheet to capture continuing education data beginning with the 2013-2014 program year. The spreadsheet contains mulitple tabs which capture all of the data for CE programs and participants. Note: the numbers on the Word forms correspond to fields within the spreadsheet.

• CE FieldGuide Spreadsheet

WEB FORMS

Below is the link for the web-based CE registration form. The information entered into these forms go directly into the AHEC database. The page will open in a new window.

• CE Participant Registration (For AHEC Center data submission only)
• CE Report Form (For AHEC Center data submission only)