Ready to Grow at 211 Connecting Point, 208 Sutton Way, Grass Valley, California 95945

Welcome to the Ages & Stages Questionnaires (ASQ) online screening program.

Because your child's first 5 years of life are so important, we want to help you provide the best start possible for them. The Ages & Stages Questionnaires were created to help you keep track of your child's development. You can complete the questionnaires every 2, 4, or 6 months, depending on your preference. The ASQ includes questions about your child's communication, gross motor, fine motor, problem solving, and personal social skills. It will help you get a better sense of whether or not your child is meeting developmental milestones.

If you would like personal assistance with the questionnaire, in person or by phone, please call 2-1-1 for an appointment.

Start the screening below by entering your child's birth date and the number of weeks he or she was born premature (if applicable). 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.

Child Date of Birth
Format: yyyy-mm-dd

Weeks Premature
(put "0" if not premature)

Screening Date

I am screening my child today (2024-04-23) 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. I understand that after I complete the screening, I will receive a phone call and/or email from Connecting Point (the home of 211 Nevada County) regarding the test results and community resources.

Connecting Point is conducting child development screening and referrals in collaboration with First Five Nevada County. All information collected on this call will be held as confidential between Connecting Point and First Five Nevada County.

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.