SVT Health & Wellness Center
907-435-3210
880 East End Road
Homer, Alaska 99603
www.svthw.org

Welcome to the SVT Health & Wellness online ASQ system! 

Answering the following series of questions can be a fun, learning experience for you and your family.  It is most effective when you do the activities with your child, while filling out the questionnaire.  Turning this into a game can make for a great experience!  

Your child's care team will review your questionnaire before your visit.  Please contact us today at 226-2228 with any questions about the screening process, results, or other concerns you have.

View description Hide description

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)

By continuing and completing the ASQ online you are agreeing to a consent for the screening of your child and have read and understand the information regarding ASQ online. 

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.