Seaford School District
302-629-4587ext. 2054
390 N. Market St. Ext.
Seaford, Delaware 19973

(put "0" if not premature)

For ASQ-3™ English

For ASQ:SE-2™ English

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 understand information will be shared with Delaware Office of Early and the Delaware Department of Public Health to determine developmental trends for making budget and resource allocations . Screening results will also be shared with your childcare.

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.