Bingocize Leader Resources

Update on Fall Prevention Program Funding and Reporting

The 2019 Administration for Community Living (ACL) grant to the Illinois Pathways to Health (ILPTH) Initiative has concluded.

If you are facilitating fall prevention workshops under other current funding received from AgeOptions, please continue to register your workshops and submit participant data through the ILPTH website.

If you are not currently funded by AgeOptions but continue to offer fall prevention workshops, we still strongly encourage you to register your workshops and submit participant data and pre/post surveys.

Why Should You Register Your Workshops?

Registering workshops and submitting data benefits everyone involved:

• Increased visibility: AgeOptions has invested in media campaigns—including commercials, banner ads, redirecting, and geofencing—to raise public awareness of ILPTH workshops and enhance your organization’s visibility.
• Leader support: We monitor leader certifications and will notify you when renewal is needed.
• Access to technical assistance: Ongoing support from AgeOptions is available for your workshops.
• Data Reports: You'll receive access to both workshop-level data and participant survey reports.
• Support for future funding: Data collection strengthens AgeOptions' proposals for continued statewide health promotion funding.

If you would like to submit participant data but will not be entering it directly into ILPTH, email forms to joan.fox@ageoptions.org.

Course Materials for Leaders

ILPTH Program Quick Reference: Guidance on facilitating Bingocize, including participant limits, session cutoffs, workshop lengths, and session times.

Data Collection Checklist: Instructions for collecting data from registration through to the final session.

Attendance Sheet: For tracking participant attendance and received forms.

Participant Form Tracker: For tracking participant forms. Please use if sending data to AgeOptions for data entry. 

Participant Sign-In Sheet: An optional sign-in sheet for participants (not required).

Session 1 Data Collection Script: A script to read aloud to participants during Session 1 — English — Spanish

Session 1 Virtual Data Collection Script: A virtual version of the Session 1 data collection script — English — Spanish

Photo Media Release: Optional; use this form if collecting testimonials or taking pictures. Feel free to customize it for your organization — English — Spanish

Exercise Only Leader Packet

Falls Prevention Leader Packet

Nutrition Leader Packet

Forms for Participants

Participants have several options for completing their paperwork:

• Paper Forms: Complete a traditional paper form or a fillable PDF.
• Electronic Forms: Receive a link to complete an electronic form through Microsoft Forms.
• ILPTH Portal: Register for the IL Pathways website participant portal and complete forms directly in the portal.

Note: If using Microsoft Forms, surveys will be submitted directly to AgeOptions, which will handle the data entry.

Session 1 Participant Registration Forms and Pre-Survey

Choose one of the following options:

1. Printable/Fillable Forms:

• Participant Registration Packet: English — Spanish
• Participant Pre-Survey: English — Spanish

2. Electronic Forms:

• Link to Electronic Registration Packet & Pre-Survey: Email info@ilpathwaystohealth.org to request a survey link.

3. ILPTH Portal:

• Participant Guide for ILPTH Portal : Instructions for completing electronic forms in the portal.

Note for Spanish participants: The surveys on the portal are in English only, unless the participant has a computer that is already set up to translate the page to Spanish.

Session 1 Handouts for Participants

(One form per participant)

Welcome Letter: Intro to the program and form instructions — English — Spanish

Exercise Only Take Home Cards

Falls Prevention Participant Packet

Falls Prevention Take Home Cards

Nutrition Participant Packet

Nutrition Take Home Cards

Last Session Forms

Choose one of the following options:

1. Printable/Fillable Forms:

• Participant Post Survey: English — Spanish

2. Electronic Forms:

• Link to Electronic Post Survey: Email info@ilpathwaystohealth.org to request a survey link.

3. ILPTH Portal:

• Participant Guide for ILPTH Portal: Instructions for submitting Session 1 and Last Session forms.

Note for Spanish participants: The surveys on the portal are in English only, unless the participant has a computer that is already set up to translate the page to Spanish.

Links and Other Materials

• Email Templates: For leaders to send to participants for online workshops — English — Spanish
• Zoom Instructions: For online workshops — English — Spanish

Marketing Materials

• IL Pathways to Health Logo
• ILPTH Evidence Based Program Flyer
• Falls Series Program Flyer
• Home Safety Checklist: Feel free to update the flyer with your organization's logo — English — Spanish
• ILPTH Outreach Toolkit Template: This Toolkit includes templates for flyers, posters, social media posts, etc. You will need to have a Canva account to access the template and create a COPY to make edits (DO NOT EDIT THE TEMPLATE). If you need help, refer to our ILPTH Outreach Toolkit User Guide.