Problem: Between 2017 and 2020, 14.7 million (19.7%) children and adolescents were reported to be obese with higher rates in Hispanic and African American children. A retrospective chart audit completed in 2023 at a suburban pediatric primary care office indicated 26% (n = 256) of children ages 6-13 were overweight or obese. Root cause analysis identified gaps in standardized obesity screening, individualized nutrition counseling, and referral for obese children. Purpose: The purpose of this quality improvement project was to implement standardized obesity screening, nutrition counseling and referral for overweight and obese school aged children in a pediatric office. Methods: Text macros were created in the EHR for standardized documentation. Guardians of children ages 6-13 years with body mass index (BMI) measurements ≥85% at well visits completed the Healthy Habits Questionnaire (HHQ) on an office iPad using a QR code. HHQ responses were reviewed by the provider and participants received individualized nutrition counseling and handouts. Patients with BMI >99% were referred to a weight management program. All participants were requested to schedule follow-up appointments. Results: One hundred percent of team members (n=10) were trained prior to implementation. Over 15 weeks, 90% identified as overweight or obese received individualized nutrition and weight counseling. Since implementation, 6% (n=8) of children were referred to nutrition and weight management programs and 20% (n=24) returned for follow-up. Conclusions: Text macros improved nutrition counseling documentation without adversely affecting provider workload. Parents were receptive to individualized nutrition counseling as an alternative to targeted weight management information. Keywords: childhood obesity, individualized nutrition counseling, overweight