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 The Nutrition and Physical Activity Coalition Self-Assessment Tool is designed to give you an idea of the strengths and weaknesses of your coalition and help direct your current and future functions. The tool will ask you a number of questions with assigned point values and then provide you with a "score" at the end. The score and related recommendations should help you in making your coalition as functional as possible given your resources.

The survey tool should be completed by the coalition chair or a core group of coalition members.

The survey will take about 30 minutes to complete. You may want to download the pdf version of the survey and complete that by hand with key coalition members and then transfer the results to the online survey. When you complete the survey you will be given the option at the end to print your results and receive your score. An explanation of the score can be found on the web page that provided the link to this self-assessment survey.

If you have questions or technical problems with the survey, contact Jon Morgan at (608) 266-9781 or jonathon.morgan@wi.gov

Thank you.


  Select Survey – Key Instructions

1. The Survey Times Out after 1 Hour
. This survey tool has a “time-out” setting of one (1) hour, which is activated when you open the survey and resets each time you move to the next “Page”.

2. Saving Your Work. Because of this setting, you must move at least to the next “Page” or finish the survey within 1 hour for your work to be saved. When you move to the next page the clock is reset for 1 additional hour. (When you select “Next” at the bottom of each page or “Done” at the end of the survey, your work to that point is also saved).

3. Coming Back To Your Survey Answers. If you can’t finish the survey in one sitting, you can select “Next” or “Done”, exit the survey, and then you can return at a later time to edit or add to your saved responses. You will need to use the same computer if you return to the survey, since that IP address will be the only way to automatically find your earlier responses. (Make sure that you finish a “Page” or section before leaving the survey if you’re going to be away for over an hour. You can return to your survey by clicking on the original hyperlink sent to you via email).







ex. Web: mywebsite.com






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