State of Hawai‘i, Department of Health

Children with Special Health Needs Branch


Hi‘ilei Developmental Screening Program

741 Sunset Avenue

Honolulu, HI 96816

Phone: 808-733-4971

Email: [email protected]


Aloha! Welcome to the Hi‘ilei Developmental Screening Program! Because the first five years of life are so important, we are here to assist you with tracking your child’s development and to help you provide the best start for your child.


You are invited to participate in the Ages & Stages Questionnaires®, Third Edition (ASQ®-3) for the Hi‘ilei Program. The questionnaires include questions about activities children, around a specified age range, may do in the areas of Communication, Gross Motor, Fine Motor, Problem-Solving, and Personal-Social. A questionnaire may be provided every 2-, 4-, or 6-month period. It is a fun and interactive way for you to learn about, track and help promote your child’s development!


To complete your child’s enrollment and start a screening, please enter your child’s birth date and the number of weeks your child was born premature below. (The number of weeks premature is based on a 40-week pregnancy. For example, if baby was born at 35 weeks, 40 – 35 = 5 weeks premature).


Please note that the information you enter into this website is secure and cannot be seen or accessed by anyone other than the Hi‘ilei Developmental Screening Program staff, who have invited you to participate.


Thank you and we look forward to your participation!


(put "0" if not premature)

By proceeding with this form you agree to allow Hi'ilei Developmental Screening Program to review your answers and send you information.



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.