A To Z Building Blocks - CC
195 N 100 E
American Fork, Utah 84003

Welcome to the Utah Department of Health's, Ages and Stages Questionnaire® (ASQ) program; in partnership with A to Z Building Blocks!!

Thank you for taking the time to complete this questionnaire.  A to Z Building Blocks is a place where children are loved, taught and given opportunities to grow.  Assessing children is a great tool to know where we can better serve our families!

We feel that the early years of a child are very critical to a child's life.  By participating in this assessment tool we will be able to work together to make sure that your child is developing the way he/she is supposed to.  Completing this questionnaire gives A to Z Building Blocks permission to conduct assessments with your child too.  A to Z Building Blocks will make the parent fully aware of any concerns and provide additional resources to seek further help.  A to Z Building Blocks will not diagnose any special need and will only refer you to outside sources.

This developmental screening opportunity is provided by the Utah Department of Health (UDOH). UDOH partners with early care and education providers, to ensure all families with young children have access to developmental screening.

Use of Data

Early childhood programs rely on data to inform decisions about effective early childhood policy and services. Data helps UDOH understand which practices work best and provide evidence to advocate for additional funding to best support Utah families and young children.

Participation in ASQ online is optional. A-Z Building Blocks partners with UDOH to collect basic information about your family and the services provided. UDOH is committed to protecting the personal data it maintains on behalf of its citizens.  The UDOH Privacy Policy and Consent to Use of Data is available here

To get started with the ASQ Online Questionnaire, please enter your child's birth date and the number of weeks he or she was born premature below to start the screening. 


(put "0" if not premature)

IMPORTANT: By submitting data and/or using this website, you give your consent to the use of your personal data and developmental screening data as described in the UDOH Privacy Policy and Consent to Use of Data.

If you do not wish to share data, do not enter data into ASQ online. Please let A-Z Building Blocks know and they will provide you with a paper copy of the ASQ.

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.