Kimberly Area School District
425 S Washington St
Combined Locks, Wisconsin 54113
(920) 788-7900, ext. 4139
thammen@kimberly.k12.wi.us
www.kimberly.k12.wi.us

Welcome to Ages and Stages! Please complete the questionnaire about your child.

View description Hide description

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)

If the questionnaire shows that your child is developing without concerns, we will provide some ideas about how to encourage your child's development.

If the questionnaire shows some possible concerns we will arrange an appointment for further screening.  

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.