Thank you for your interest in “My Life, My Health”
The Stanford University Chronic Disease Self-Management Program.


In order to participate in the Leader Training you need to review and complete the attached forms in the order listed:

   1) The Stanford University Chronic Disease Self-Management Education Programs Massachusetts My Life, My Health Leader Qualifications & Requirements – Please read and review prior to moving to the next forms. Feel free to ask questions if you need more information before going forward with the following forms.

Qualifications & Requirements Form

   2) Welcome Prospective Leader Form: Needs to be completed prior to training and sent back to Silvia Dominguez-Bodie

Prospective Leader Form

   3) CDSME Leader Application Form – Needs to be completed prior to training and sent back to Silvia Dominguez-Bodie

Leader Application Form

   4) CDSME Leader Agreement Form - please bring this form to the training, you will need to submit it on the last day of the training. 

Leader Agreement Form

The Leader Application Form for the upcoming working: My Life, My Health Chronic Disease Self-Management - June 10, 11, 17 & 18 - 9:00 to 4:00 pm is due no later than May 30th, 2014.

We will confirm your registration into the Leader Training after we review all the forms.


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