Cancer Clear & Simple Participant Sign-In Sheet
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2Cancer Clear & Simple: Sign-In Sheet
Instructions to the facilitator: Please clearly print the session information and participant names
below. Write participants’ names as they appear on their ‘Participant Consent Form.’
Write in the date of each session below. Write the date under each session that you facilitated.
Multiple sessions can be facilitated on the same date. Place a check mark under the session that
each participant attends.
Facilitator Name: ____________________________________________________________
Location of class: ___________________________________________________________
Start Date (mm/dd/yyyy):
End Date (mm/dd/yyyy
__ __/__ __/__ __ __ __
): __ __/__ __/ __ __ __ __
Session
Session
Session
Session
Session
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Participant Name
Date:
Date:
Date:
Date:
Date:
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_____
_____
_____
_____
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