Help Me Grow Lake County
Phone: (352) 435-0566, Extension 211
1300 Citizens Blvd., Ste. 206
Leesburg, Florida 34748

Justine Reina, Help Me Grow Care Coordinator

Business Hours:  Monday - Thursday, 8:00am - 6:00pm.  Fridays - Appointments ONLY.

(put "0" if not premature)

For ASQ-3™ English

For ASQ:SE-2™ English

I have read the provided information about the Ages & Stages questionnaires, and I wish to have my child participate in the online screening program. I will fill out the questionnaire about my child's development and promptly submit the completed questionnaire through this Family Access online questionnaire completion system.

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.