A team comprised of one nurse administrator, three nurse clinicians, and two nurse researchers developed the Child Health Indicator Assessment (CHIA), an assessment tool that monitors all 10 of the Healthy People 2010 Leading Health Indicators in a pediatric nurse-managed practice. The CHIA is a survey to be administered in a clinic setting, which facilitates regular health maintenance history-taking on 10 key health indicators and provides annual prevalence data on the health of one clinic-based population. CHIA Part A solicits parent or adolescent self-report data at routine health supervision visits. CHIA Part B is completed by a nurse practitioner after the well child visit and includes information collected from chart review. The survey development process presented several challenges but resulted in an easy-to-use, clinically relevant instrument. The data from the CHIA will be used to guide clinic-wide interventions to improve and promote pediatric health in two key areas each year.