Below you will find a link to complete the Ages and Stages Questionnaire online screening. This will help us partner with you to celebrate your child’s strengths and discuss additional support if needed, ensuring a smooth and successful transition into school

This survey is a quick way for you to share observations about your child’s current milestones. The questions are specifically tailored to your child’s age and focus on five key areas:

 

• Communication: Language skills and understanding.

• Motor Skills: Physical movement and coordination.

• Problem-Solving: How your child plays and interacts with toys.

• Personal & Social: Self-help skills and interactions with others.

• Social-Emotional: How your child expresses and manages feelings.

A school representative will follow up with you in the coming days regarding the results of your screening

**PLEASE CHOOSE FIRST OPTION; I am completing both the ASQ-3™  and ASQ:SE-2™ questionnaires**

Child Date of Birth

Month Day Year

MM 01 02 03 04 05 06 07 08 09 10 11 12 DD 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 YYYY 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 2026

Child DOB you entered is in the future, are you sure of that? (Please correct the date before proceeding to the next step). Please enter your child's DOB and not the screening date or today's date (Please correct the date before proceeding to the next step). Child DOB you entered is not valid, please format the date like this: MM-DD-YYYY

Weeks Premature
(put "0" if not premature)

Screening Date Options

For ASQ-3™ English

Screening Date

List others assisting with completion of the questionnaire

For ASQ:SE-2™ English

Screening Date

List others assisting with completion of the questionnaire

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.

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.