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South Carolina Obesity Resource Directory

South Carolina Obesity Initiative Form

Completing this form gives you a great opportunity to spotlight your ideas and inform positive efforts at the local level.

Note: Your entry will be reviewed for appropriateness and relevance. The decision to alter or post information will be at the discretion of DHEC. The appearance of your information on or official links to your website from the DHEC website does not constitute an official endorsement of your organization, products or services.

Please complete one form per initiative.
* indicates a required question

*Initiative Name:    Additional Info Icon

*When did the initiative start?  (MM/YYYY)

*How is the initiative funded? (Select all that apply)





*Which of the following attributes describes the focus of your initiative? (Select all that apply)
Nutrition/Healthy Eating
Physical Activity/Active Living
Breastfeeding
Childhood Obesity
Adult Obesity
Obesity Related Research


*Which of the following environments does your initiative impact? (Select all that apply)







*Which group does your initiative target?
Gender (Select all that apply):



Race (Select all that apply):






Ethnicity:



*Which specific populations below does your initiative target? (Select all that apply)







*Which age group does your initiative target? (Select all that apply)






*Which county does your initiative serve? (Select all that apply):

*Please provide a brief description of the initiative that can be used to create an overview
for the SC Obesity Resource Directory (Descriptions may be modified at the discretion of DHEC.)
(Character Limit: 1,000)

*If you collect information about the impact of your initiative and/or if your initiative has
demonstrated measureable outcomes, please explain the results. (Character Limit: 1,000)

*Name of organization or coalition:

*Organization Description:

*Type of organization:        Other (please specify):

*Organization Street Address:

*City:        *Zip Code:
                                                                     
 Phone Number:        Website:
                                           
*Primary Contact Name:

 Primary Contact Phone:

*Primary Contact Email:

 Primary Contact Title:

      

Please email your comments, questions, or concerns to Obesity_info@dhec.sc.gov.