Community Nutrition, Exercise, & Weight Management Resources Assessment
Please answer the following questions to help us create a directory of resources for nutrition, exercise, and weight management programs in Kane County. Please forward this questionnaire to other departments within your organization that also provide programming related to nutrition, exercise, or weight management.
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Name of organization *
Description of organization (optional)
Address of organization *
Phone number of organization *
Organization website *
Contact Name *
Contact Email Address *
Contact Phone #
What types of education or community resources (education, classes, tools, etc.) does your organization provide to promote health and wellness? Please select all that apply. *
Required
The utilization of these community resources (education, classes, tools, etc.) is
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Please list any known barriers to your program utilization  (cost, transportation, etc.)
Are  your health and wellness promotion resources (please select all that apply)
What types of nutrition, exercise, and weight management programs and services does your organization provide? (please select all that apply) *
Required
Please provide the specific link to your organization's nutrition resources/programs
Please provide the specific link to your organization's exercise resources/programs
Please provide the specific link to your organization's weight management resources/programs
Are your nutrition, exercise, or weight management resources available in other languages other than English? *
Are your nutrition, exercise, or weight management resources also available in
Please check the ethnicities that were considered when designing your nutrition, exercise, or weight management resources.
Would you like your organization to be listed in the Kane County Resource Directory?
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Submit
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