Ventura County Public Health -Children's Health Promotion
(805) 981-5240
2240 E. Gonzales Road Suite #250
Oxnard California 93036   

Welcome to our ASQ Online screening program!

Ventura County Public Health offers free online developmental screening using the Ages and Stages Questionnaire, Third Edition (ASQ -3).  We are funded by First 5 Ventura County and are a partner in Help Me Grow Ventura County.  Help Me Grow Ventura County is a network of programs that support young children’s development. 

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.

By entering your information and your child’s information into the ASQ Online, you are also consenting to this information being shared with First 5 Ventura County and entered into their database.  First 5 Ventura County’s database is designed for our program to enter developmental screening data and information on referrals and outcomes.  First 5 Ventura County will evaluate and report aggregate data to funders and collaborative partners that will not contain personal or identifying information.  The data will help them understand which strategies work best and provide evidence to advocate for additional funding to support the families in our county.

Additionally, if you provide us with your email address, you are giving us permission to communicate with you and send you the screening results via email.  Please note that the information you enter into the ASQ Online website is secure and can only be accessed by Ventura County Public Health and First 5 Ventura County.

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.

If you wish to participate but do not wish to share data, do not enter data into ASQ online. Instead please call the number listed above and we will provide you with a paper copy of the developmental screening questionnaire.

To get started with the ASQ Online Questionnaire, please enter your child's birth date and the number of weeks he or she was born premature below to start the screening.



(put "0" if not premature)

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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.