Marin Community Clinics

Ages and Stages Screening Program
415.448.1500
www.marinclinics.org

Welcome to the Ages and Stages Developmental Screening Program. We are excited to have you participate in on-going screenings of you're child's overall development. It is by working together as parents, caregivers and providers that we can help to bridge any gaps in a child's development and offer resources and support services to help them continue to grow and learn.

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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)

By clicking "submit" you are consenting to participation in the Ages and Stages Developmental Screening Program.

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.