Sunshine Community Health
HC 89 Box 8190
Talkeetna, Alaska 99676

Welcome to Sunshine Community Health Center's online screening. Each questionnaire takes 10–15 minutes for parents to complete and just 2–3 minutes for professionals to score.

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Because your child's first 5 years of life are so important, we want to help you provide the best start for your child. You've been invited to participate in the Ages & Stages Questionnaires, Third Edition (ASQ-3), to help you keep track of your child's development. The questionnaire may be provided every 2-, 4- or 6-month period. You will be asked to answer questions about some things your child can and cannot do. The questionnaire includes questions about your child's communication, gross motor, fine motor, problem solving, and personal social skills.

Please enter your child's birth date and the number of weeks he or she was born premature below to start the screening. Please note that the information you enter into this website is secure and cannot be seen or accessed by anyone other than the program employees who have invited you to participate in this screening.

We look forward to your participation in ASQ-3!

(put "0" if not premature)

The State of Alaska, Early Intervention/Infant Learning Program (EI/ILP) has provided funding to offer the Ages and Stages Questionnaires online for ease of access by parents. I understand that the State of Alaska, Department of Health and Social Services, as the lead funding agency, will receive data on children who obtain Early Intervention/Infant Learning Services. This is in accordance with state and federal laws and is for the purposes of program management and evaluation. All information collected will be treated as confidential and is protected under the Family Education Rights and Privacy Act (FERPA) and Health Insurance Portability and Accountability Act (HIPPA). We are committed to your privacy and the privacy of your child. Any information you submit in the ASQ Online system can only be seen by our staff who have authorized access to your account. No information will be shared without your written consent. The State of Alaska EI/ILP will have access to combined data without identifying information. As the parent or legal guardian of this child, you are agreeing to these terms by completing the questionnaire and have access to this information as part of your child’s records.

Note: By clicking "Submit", you are agreeing to both our Family Access End User License Agreement and any other consent or authorization information outlined on this page.