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Luxemburg Caasco School District
920-845-5549
[email protected]
112 N Main St
Luxemburg, Wisconsin 54217

Below you will find a link to complete the Ages and Stages Questionnaire online screening to help keep track of your child's development as part of our Playgroup!

You will be asked to answer questions about some things your child can and cannot do. The questionnaires include questions about your child's communication, gross motor, fine motor, problem-solving, personal-social skills, and social-emotional skills.

If you are completing this as a grandparent or other caregiver that is not a problem, just indicate as such as you complete it. If you do not feel comfortable doing so please share this information with parents to complete this evening!

Welcome to our ASQ Online screening program!

Child Date of Birth

Month Day Year

Weeks Premature
(put "0" if not premature)

Screening Date

I am screening my child today (05-09-2025) I screened my child and am entering in the responses to a previous screening

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.