Oakland County Help Me Growwww.greatstartoakland.org844.456.5437www.facebook.com/greatstartOC
Child Date of BirthFormat: yyyy-mm-dd Child DOB you entered is in the future, are you sure of that? (Please correct the date before proceeding to the next step). Please enter your child's DOB and not the screening date or today's date (Please correct the date before proceeding to the next step). Child DOB you entered is not valid, please format the date like this: YYYY-MM-DD
Weeks Premature (put "0" if not premature)
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Participation in this project is voluntary and at no cost to you. Your child's results are confidential and will not be shared outside of Help Me Grow-Oakland Early Childhood data system. Your child's non-identifying information will also be combined with that of others in this program for learning purposes. By completing the online ASQ, you give your consent to participate. We will send your child's results by email. Based on these results, we may contact you about early childhood services in which your child may be eligible.
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