Cape Henlopen School District
820 Savannah Rd.
Lewes, Delaware 19958

(put "0" if not premature)

For ASQ-3™ English

For ASQ:SE-2™ English

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.  These results are being collected by the DE Department of Education and the DE Department of Public Health to determine trends and assist with where state resources are needed.  

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.