Website Developmental Screening
949-267-0360
lginter@uci.edu
2500 Red Hill Ave.
Ste. 290 B
Santa Ana, California 92705
www.helpmegrowoc.org

 

Welcome and thank you for taking an important step in better understanding your child’s growth and development. They grow fast – crawling, walking and talking before you know it. That’s why Help Me Grow Orange County is helping you and your child’s doctor follow your child’s development, every step of the way.

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. By entering your child's information into this website, you are consenting to your child's information being entered into the OC Children's Screening Registry, an online database designed to enable primary healthcare providers and community based providers to view and/or enter developmental and behavioral screening data and share information on referral and outcomes.

The information you enter into this website is confidential and can only be accessed by Help Me Grow staff. However, information entered into the OC Children's Screening Registry can be accessed by Help Me Grow and authorized OC Children's Screening Registry users.  Please note that you can opt out of sharing your child’s information in the OC Children’s Screening Registry when completing the Child Information Section during this registration process or at any time in the future by contacting Help Me Grow Orange County, without any consequences to receiving services. You acknowledge that your opting out cannot and will not recall information that has previously been released in reliance upon your consent provided herein.

We look forward to your participation in the ASQ-3!



(put "0" if not premature)

Help Me Grow Orange County is your local connection to developmental services to enhance the development, behavior and learning of your child. By completing this questionnaire, you are giving your consent to allow their trained staff to review your child's ASQ-3 and mail you the results along with a list of fun activities for you to do with your child. If we have any questions about your child's ASQ-3, we will contact you by phone at the number you provided.  If you want your child's health care provider to receive a copy of the results, please add their information when prompted. Learn more about Help Me Grow Orange County at http://www.helpmegrowoc.org

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.