Brookes ASQ | ASQ:SE2 - ASQ-3 English

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Poudre School District Early Childhood Education
970-490-3204
[email protected]
220 N Grant Ave
Fort Collins, Colorado 80521
https://www.psdschools.org/programs-services/early-childhood-education

Thank you for your interest in Poudre School District's Early Childhood Education Program! As part of the application process, each family must complete both the ASQ-3 and the ASQ:SE-2 screening surveys. Please click the first link below to access and complete both surveys for your child. Please note that the information you enter into this website is secure and cannot be seen or accessed by anyone other than the Early Childhood Education employees who are determining your child's eligibility.

Program applications cannot be processed without the completion of these surveys.

Child Date of Birth
Format: yyyy-mm-dd
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: YYYY-MM-DD

Weeks Premature
(put "0" if not premature)

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.