Weeks Premature
(put "0" if not premature)

List others assisting with completion of the questionnaire

For ASQ:SE-2™ English

List others assisting with completion of the questionnaire

By completing this screening, you are giving consent for the CARE Coordinator to contact you with the screening results and to discuss any follow-up that may be needed. You will receive a CARE Kit that contains community resources and activities relevant to your child's age and stage of development. 

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.