Healthier Living Host Site Application

To meet the needs of older adults and their caregivers, Aging & Independence Services (AIS) provides free virtual and in-person Healthier Living with Chronic Disease, Diabetes, and Chronic Pain workshops. Developed by Stanford University, this evidence-based program is fun, highly interactive and focuses on support, skill development, sharing and building confidence to manage a chronic health challenge. Participants learn how to set goals for their health and stick to them, read food labels and meal plan, manage stress and difficult emotions, talk with their healthcare provider about symptoms, and more. Participants receive a free Living a Healthy Life with Chronic Conditions book and relaxation CD for their participation.

If you are interested in being a host site for this program, please complete the application below. If you have any questions, please contact Carolyn Kendle at CarolynM.Kendle@sdcounty.ca.gov.

Question Title

* 1. Site Information

Name *

Address

City/Town

State/Province

ZIP/Postal Code

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* 2. Contact Information

Name

Email Address

Phone Number

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* 3. Briefly describe the demographics of participants, including any special needs or limitations.

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* 4. Is there a liaison available to relay messages between participants and the instructors (for example, if instructor is sick and cancels)?

Yes

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* 5. Please select the workshop format you are interested in below.

In person

Virtual

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* 6. Please select the workshop curriculum you are interested in below.

Chronic Disease (base curriculum)

Diabetes

Chronic Pain