{Help Me Grow North Texas}
817-360-2533
Leann.Turbeville@mhmrtc.org
3840 S Hulen
Ft. Worth, Texas 76017

 

 

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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. If I was referred by a child care center, I understand that my results will be shared with the center. I also understand de-identified results will be compiled and shared with other entities* for evaluative and research purposes. 

**Other Entities may include, but are not limited to:

Early Learning Alliance

Department of State Health Services

Prevention Early Intervention  

My Health My Resources (MHMR) Tarrant County

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.