2011 AAP Chapter Assessment on Adolescent Health

We would like to learn more about what is happening in your chapter related to adolescent health. In addition, your response is very important in helping the AAP Section on Adolescent Health develop activities and resources that can support your chapter's adolescent health initiatives. It should take about 15-20 minutes to complete this survey.

We have invited multiple chapter leaders to complete the survey for each AAP chapter, so more than one response per chapter is preferred.

Question Title

1. Please provide the following information:

Your name:

Your AAP Chapter:

Your chapter title/position:

Question Title

2. Does your chapter have a committee that specifically addresses adolescent health (e.g. Committee/Council on Adolescent Health, Sports Medicine, Substance Use or Youth Development)?

Yes

No (Skip to Question 5)

Question Title

3. Please describe the chapter committee that deals with adolescent health issues.

What is the committee's formal name?

Who is the current chairperson?

Question Title

4. Please describe the activity level (regarding adolescent health issues) of the chapter committee that deals with adolescent health issues.

Inactive

Irregular activity

Ongoing activity

Extremely active

Question Title

5. Please briefly describe up to 3 chapter activities or accomplishments in the area of adolescent health that occurred in the past 2 years.

Accomplishment #1

Accomplishment #2

Accomplishment #3