Worksheet for support group work

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ariemens

Worksheet for Support Group Work

Health & Medicine

Worksheet for Taking Pictures for Photovoice Project:
Bring this worksheet with you (one for each picture) to your support group meeting.
What question is related to the picture?
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
Date Picture was taken:
_____________________________________________________________________________
What is this picture of:
_____________________________________________________________________________
Write down in a couple of sentences or a paragraph on why you took this picture? What
does it mean to you?
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
**Are you willing to share this picture and your above story with Joyce (researcher for
project) to be used to increase knowledge and understanding of what it is like to live with
Parkinson’s disease or to live with someone who has Parkinson’s disease?
______ Yes ________No
If yes, please sign your name:
_________________________________________________________Date:________________
Signature to allow pictures and stories to be used for publication/public

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