Complete the following form to submit a nomination for your organization or another organization for the PHA Impact for Change Award.

The Impact for Change Awardee must demonstrate how the organization or individual is successfully doing one or more of the following to help make the healthy choice the easy choice:

· Showing measurable impact and outcomes with a focus on the populations disproportionately impacted by obesity, 
· Collaborating with other organizations in the childhood obesity effort to create a greater impact; or
· Using an innovative approach to addressing the mission to end the childhood obesity crisis.