Timberline Learning Center
970-453-9656
info@timberlinelearningcenter.com
P.O. Box 3098
Breckenridge, Colorado 80424

Dear Parent/Caregiver:

Thank you for participating in our child screening/ monitoring program. The Ages & Stages Questionnaires®, Third Edition (ASQ-3™) online, is a screening tool that will provide a quick check of your child’s development.  The information you supply will help reveal your child’s strengths, uncover any areas of concern, and determine if there are community resources or services that may be useful for your child or your family.

 

ASQ-3 is a set of questionnaires about children’s development. It has been used for more than 20 years to make sure children are developing well. It is called a screener because it looks at how children are doing in important areas, such as speech, physical ability, social skills, and problem-solving skills. ASQ-3 can help identify your child’s strengths as well as any areas where your child may need support.

You are an active partner in your child’s learning and development. By completing ASQ-3 questionnaires, you are making sure your child is off to the best possible start!

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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)

I have read the information provided about the Ages and Stages Questionnaires, Third Edition (ASQ-3), and I wish to have my child participate in the screening/monitoring program. 

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.