801-691-5322
helpmegrow@unitedwayuc.org
helpmegrowutah.org

Welcome to the Ages and Stages Questionnaire with Help Me Grow Utah!

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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)

When using Help Me Grow Utah (HMGU), basic information is collected about your family and the services provided. With your permission, HMGU communicates with your family’s physician(s) and other providers. HMGU also teams with other entities to share data that gives an overall view of how Utah’s children are doing. With some places, your personal information will be shared only during data transfer. In all cases it will be removed before use in research, community coordination or to inform future decision making. By using HMGU services, you are consenting to the sharing of your information unless you ask otherwise. For more details, visit: helpmegrowutah.org or talk to a HMGU staff member.

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.