Local Wellness Policy Report Card Online Tool
In 2010, the Healthy, Hunger Free Kids Act was passed, which expanded upon previous requirements and included new provisions that place a greater emphasis on the implementation, evaluation, and transparency of local wellness policies. Schools may elect to use the Local Wellness Policy Report Card as a method for communicating the results of the school/district evaluation. Following completion of this form, responses will be submitted to Wisconsin Team Nutrition. A report compiling your answers will be generated and emailed to you.

To complete the report card, enter all objective statements found in your Local Wellness Policy under the appropriate category. There are six categories that comprise a comprehensive policy: Nutrition Standards for All Foods, Nutrition Promotion, Nutrition Education, Physical Education/Activity, Other School-Based Wellness Strategies, and Monitoring/Implementation. You do not need to have objective statements under each category to complete the Report Card. Each category has space for ten objectives. If additional space is needed, please contact Alicia Dill (alicia.dill@dpi.wi.gov) or Kelly Williams (kelly.williams@dpi.wi.gov).
School/District *
Your answer
School/District Address *
Your answer
Date of Policy Adoption *
MM
/
DD
/
YYYY
Date of Policy Review *
MM
/
DD
/
YYYY
Wellness Policy Coordinator Name *
Your answer
Email Address *
A valid email address is required to receive a copy of your completed report card.
Your answer
Contact Person (if different from coordinator)
Your answer
Contact Person Email Address
Your answer
Next
Never submit passwords through Google Forms.
This form was created inside of Wisconsin Department of Public Instruction. Report Abuse