{Families First}
{100 Campus Dr. Suite 12}

 {Portsmouth}, {NH}  {03801}
{(603)422-8209}

{  https://www.familiesfirstseacoast.org/

 

For the Family Center: https://www.familiesfirstseacoast.org/family-programs/parenting-classes-family-groups/}

Like a yardstick for measuring height, developmental screening is a tool that helps families measure their child’s development through the years. NH’s goal is that all families will have FREE access to developmental screening for their young children, receive information about child development, or be provided with referrals to appropriate state and local resources.

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 an Ages & Stages Questionnaires, Third Edition (ASQ-3), online screening 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.

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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 provided information about the Ages & Stages questionnaires, and I wish to have my child participate in the online screening program. I will fill out the questionnaire about my child's development and promptly submit the completed questionnaire through this Family Access online questionnaire completion system.

I give permission for WMG to share screening information with my child’s health care provider. (so that the Dr has a record and doesn't rescreen the child at the same age) 

I give permission to include my child's non identifying information in the Watch Me Grow System. The data is used to identify how many children in our state are being screened, assist with grant funding for the program, and help to guide programs that service young children and families. 

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.