Tri Valley Pediatrics
925-460-8444
5565 West Las Positas Blvd
Suite 240
Pleasanton, California 94588
http://www.trivalleypediatrics.com/

As part of our care for your child, Tri-Valley Pediatrics is now offering developmental screening for all children using the Ages & Stages Questionnaires (ASQ-3). You will complete the questionnaire online either at your well child visit or at home. Please let Tri-Valley Pediatrics staff know if you would prefer to use a paper questionnaire.

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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)

Please note that the information you enter into this website is secure and cannot be seen or accessed by anyone other than Tri-Valley Pediatrics and the program employees who have invited you to participate in this screening.

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.