Pledge to Support Survey

Question Title

* 1. I pledge to join with the U.S. Surgeon General, along with the American College of Sports Medicine, to actively promote physical activity - specifically walking - as a health care intervention. Specifically, I pledge to support and promote the Surgeon General's Call to Action to Promote Walking and Walkable Communities.

Yes, I pledge to support as an individual.

Yes, I pledge to support on behalf of my organization.

If pledging on behalf of your organization, what is the size of your organization (e.g. number of employees, students, physicians, etc.)?

Question Title

* 2. As evidence of my pledge, I will:

Keep abreast of activities related to the Call to Action and other physical activity topics.

Pledge to walk for personal health and encourage colleagues and patients to do the same.

Regularly share walking and physical activity messages via my sphere of influence.

Promote, encourage, and recognize members for engagement with walking and walkable communities and physical activity overall within my organization and community.

Other (please specify)

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* 3. Please provide your current contact information.

Name

Title

Organization

Health Care Specialty

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* 4. Which of the following goals from the Call to Action are you or your organization working on, or planning to work on, in 2016?

Make walking a national priority

Design communities that make it safe and easy to walk for people of all ages

Promote programs and policies to support walking

Provide information to encourage walking

Fill research, surveillance and evaluation gaps

Other (please specify)

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* 5. Please use the space below for any other comments about your current and upcoming work around walking and walkable communities:

Please contact ebw@acsm.org with any questions or comments.
Click here for more resources related to the Surgeon General's Call to Action to Promote Walking and Walkable Communities.