The prevention and management of pediatric obesity are challenges for primary care providers. Screening tools that efficiently capture nutrition and exercise behaviors enhance opportunities for targeted education. This quality improvement study reports the results of using the Starting the Conversation 4-12 Screening and Counseling tool in a primary care setting. The most prevalent issues identified were children not getting the recommended amount of fruits and vegetables per day, eating in front of the TV/computer, and the belief that “healthy food costs too much.” Starting the Conversation 4-12 Screening and Counseling proved to be an efficient and effective tool for prompting brief obesity management interventions.