Weeks Premature
(put "0" if not premature)

List others assisting with completion of the questionnaire

For ASQ-3™ English

List others assisting with completion of the questionnaire

Results of screening and suggested activities will be provided within two weeks of submission. This service is provided only for families who live within the cities of the Ready Region West region: Buena Vista, Covington, Lexington, Martinsville, Roanoke, and Salem; and the counties of Alleghany, Bath, Botetourt, Craig, Franklin, Henry, Highland, Patrick, Roanoke, and Rockbridge.

Individual child results will not be shared with anyone outside of Ready Region West without your permission.  Please contact us at the phone & email listed above if you have questions.

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.