Take Action! California 5 a Day—Be Active! Worksite Program: List Forms by Activity Phase

List Forms by Activity Phase

The following list shows forms and materials as needed through all phases of the Take Action! program. See "Implementing the Phases of Take Action!" for more information.

Registration Form - Fruit and Vegetable Version

Use this sample Registration Form if your Take Action! program is focusing on fruit and vegetable consumption.

Registration Form - Physical Activity Version

Use this sample Registration Form if your Take Action! program is focusing on physical activity.

Participant Evaluation Form - Fruit and Vegetable Version

Use this sample Participant Evaluation Form if your Take Action! program focused on fruit and vegetable consumption.

Participant Evaluation Form - Physical Activity Version

Use this sample Participant Evaluation Form if your Take Action! program focused on physical activity.

Team Captain Evaluation Form

A sample Team Captain Evaluation Form is provided here to be completed by the Team Captains at the end of the 10-week program.

Coordinator Evaluation Form

A sample Coordinator Evaluation Form is provided here to be completed by the Coordinator at the end of the 10-week program.

Set Your Goal - Fruit and Vegetable Version

This worksheet guides participants through the process of setting their fruit and vegetable consumption goal.

Set Your Goal - Physical Activity Version

This worksheet guides participants through the process of setting their physical activity goal.

Midpoint Goal - Fruit and Vegetable Version

This worksheet allows participants to increase or decrease their original fruit and vegetable consumption goal at the midpoint of the Take Action! program.

Midpoint Goal - Physical Activity Version

This worksheet allows participants to increase or decrease their original physical activity goal at the midpoint of the Take Action! program.

Participant Endpoint Goal Attainment/Continuation Form

This worksheet helps participants to determine their success at reaching their Take Action! goal at the end of the program. It also allows participants to committ to continuing the program beyond the initial 10 weeks.

Log - Fruit and Vegetable Version

Participants can keep track of their daily fruit and vegetable points with this log.

Log - Physical Activity Version

Participants can keep track of their daily physical activity points with this log.

Coupon - Fruit and Vegetable Version

Fruit and vegetable favor coupons can encourage participants to continue reaching their fruit and vegetable consumption goals.

Coupon - Physical Activity Version

Physical activity favor coupons can encourage participants to continue reaching their physical activity goals.

Energize Your Workday brochure

This brochure includes simple ways to enjoy fruits and vegetables during an active workday.

Recipes

These recipes are quick and easy while providing tasty ways to incorporate a variety of colorful fruits and vegetables into daily meals.

Recommended Cups of Fruits and Vegetables for Adults

These tables will help participants to determine how many cups of fruits and vegetables they need daily, according to their age, gender, and physical activity level.

Why Eat a Variety of Colorful Fruits and Vegetables Every Day?

This handout provides information on the health benefits of the seven different color varieties of fruits and vegetables.

A Handy Guide to Help You Get the Recommended Amount of Fruits and Vegetables

This handout contains pictoral examples of what appropriate portion sizes look like for several different kinds of fruits and vegetables.

Seasonality Chart

The seasonality chart shows when fruits and vegetables are readily available throughout the year.

Choose Fruits and Vegetables When Eating Out

This handout includes a few simple tips to help participants enjoy more fruits and vegetables when eating out.

Choose Fruits and Vegetables During Your Workday

This handout includes a few simple steps that participants can take to enjoy fruits and vegetables throughout their workday.

Health Benefits of Physical Activity

This handout describes the many health benefits of regular physical activity.

Keeping FITT

This handout describes the FITT formula, which can help participant's be more physically active. FITT stands for Frequency, Intensity, Time, and Type.

Physical Activity Pyramid

The Physical Activity Pyramid can be used as a guide for creating a personalized weekly program of physical activities.

Physical Activity and Exercise Safety

This handout summarizes what participants need to do before, during, and after physical activity in order to protect themselves from injury.

Stretching Exercises

This handout includes a variety of stretching exercises that are important to perform before and after doing physical activity in order to reduce the risk of injuries.

Huddles - Fruit and Vegetable Version

Here are some Team Huddle ideas on fruit and vegetable consumption.

Huddles - Physical Activity Version

Here are some Team Huddle ideas on physical activity.

Bright Ideas - Fruit and Vegetable Version

Bright ideas focused on increasing fruit and vegetable consumption are provided here.

More Bright Ideas - Fruit and Vegetable Version

Additional bright ideas focused on increasing fruit and vegetable consumption are provided here.

Bright Ideas - Physical Activity Version

Bright ideas focused on increasing physical activity are provided here.

More Bright Ideas - Physical Activity Version

Additional bright ideas focused on increasing physical activity are provided here.

Summary Report Form

This tool can be used by Team Captains to keep track of their Team members' progress throughout the 10-week program. This information can then be passed on to the Program Coordinator at the 5-week and 10-week points.

Wall Chart

The wall chart is a tool that Team Captains can use to visually display their Team members' progress towards reaching their individual goals.

Quick Start

The Quick Start Guide provides a brief outline of the implementation phases of the Take Action! program.

Sample Letter to Management

This sample letter can be used for the initial contact with management about the Take Action! program. Customize the letter using information that is unique to your company.

CEO/Management Sample Presentation

Use the following outline to make a presentation to your CEO/Top Management about the benefits and implementation process of Take Action!

Sample Letter from CEO/Management to Participants

This sample letter can be used by CEO/Management to encourage all employees to participate in Take Action!

Planning Committee Sample Meeting Agenda

Use this tool to make a presentation to the Planning Committee about the benefits and steps of Take Action!

Team Captain Sample Meeting Agenda

Use this sample agenda to make a presentation to the Team Captains about the benefits and implementation process of Take Action!

Sample Kickoff Agenda

Customize this sample agenda for your Take Action! Kickoff event.

Closing Celebration Sample Agenda

Customize this sample agenda for your Take Action! Closing Celebration.

Donation Letter

Customize this sample letter when requesting donations for your Take Action! program.