Help Me Grow South Carolina
255 Enterprise Blvd Suite 110
Greenville, South Carolina 29615
www.helpmegrowsc.org



(put "0" if not premature)

For ASQ-3™ English

For ASQ:SE-2™ English

By proceeding with this form you agree to allow Help Me Grow South Carolina to review your answers.  We would like to send a copy of the scored questionnaire to your child's health care provider. This is a free service, and allows you to work interactively with your health care teaam so they can offer better care to your family. If you do not wish to receive this service, please contact us at the information listed above and we will remove this permission from your file.

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.