AMIGAS Promise Sheet

The AMIGAS promise sheet shows the specific actions a woman has committed to take toward getting screened for cervical cancer. It presents the next steps in each woman’s personal action plan and includes a date by which she has agreed to do the actions shown. This handout can be displayed prominently in a woman’s home to remind her of the promise she has made.

How to Use the Promise Sheet

  1. Each lesson plan includes a step to complete the promise sheet. In both individual and group sessions, the community health worker will talk with women about the difficulties they have in getting screened regularly. Community health workers will ask women to try to think of ways they can overcome those difficulties. The message cards in the individual sessions, and the Three Friends game in the group sessions, give women ideas to develop her own action plan. Community health workers help women come up with solutions that will work for them, and focus on specific actions they can take.
  2. Community health workers will give each woman a promise sheet. When she has decided what her next steps will be, she will commit to those actions by completing the promise sheet. A community health worker will ask her to make a promise to herself regarding what she will do to overcome any of the difficulties she is having. What will she commit to? Using the promise sheet, community health workers will ask each woman to mark the boxes for the step or steps she will take toward getting screened for cervical cancer. If she wants to take other steps that are not listed, they can be added in the space provided.
  3. Community health workers will tell each woman that this is a promise she is making to herself and her family to stay healthy. The woman should only mark what she is really going to do.
  4. Community health workers will tell each woman she can take this promise sheet home with her as a reminder of what she has committed to do toward getting cervical cancer screening tests regularly.