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Kidney Health Coach Activity Log Form

The American Kidney Fund greatly appreciates what you do a coach. Logging your educational activities and sessions helps us keep track of coaches' progress. Please do not forget this very important step. Give us as much information as you can. Your honest feedback will help us improve the program

Please answer all responses for January 1 to December 31, 2026.

What language(s) did you conduct sessions/share kidney disease information? (Select all that apply)
Please indicate where you hosted your sessions/shared kidney disease information (Select all that apply)
Which KHC material(s) did you use when hosting sessions/sharing kidney disease information? (Select all that apply)
On a scale from 1 to 10, please indicate to what extent you utilized the KHC curriculum as outlined in the online KHC training course (Education session PowerPoint, attendee evaluation, fact sheets, flip chart, etc.).
I did not use the KHC curriculum materials
I followed the KHC curriculum using all the materials provided
One file only.
256 MB limit.
Allowed types: gif, jpg, jpeg, png, bmp, eps, tif, pict, psd, txt, rtf, html, odf, pdf, doc, docx, ppt, pptx, xls, xlsx, xml, avi, mov, mp3, mp4, ogg, wav, bz2, dmg, gz, jar, rar, sit, svg, tar, zip.

If you respond and have not already registered, you will receive periodic updates and communications from American Kidney Fund.