CVP ASQ Online
400 South McCaslin Boulevard, Suite 103
Louisville, Colorado 80027

Welcome to Centennial Valley Pediatrics ASQ Online for Developmental Screening!  We believe that raising a child is a rewarding as well as challenging experience for a parent.  Our goal is to help you to enjoy this time with your child and to ensure that your child's full potential is reached.

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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)

CONSENT: I have read the provided information about the Ages & Stages Questionnaires (ASQ-3), and I wish to have my child(ren) participate in the monitoring program. I will fill out the questionnaires about my child’s development and promptly return the completed questionnaires through the 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.