Shasta County Office of Education -Early Childhood Services
530-605-2645
helpmegrow@shastacoe.org
43 Hilltop Drive
Redding, California 96003
www.HelpMeGrowShasta.com



(put "0" if not premature)

For ASQ:SE-2™ English

For ASQ-3™ 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 and understand that the results will be saved securely in the Help Me Grow Shasta STAR database.    

 

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.