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 the Ages & Stages Questionnaires (ASQ: SE-2®) will be sent within two weeks to the email address you provide through this registration process. 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 will be reviewing this screening.

The Ages & Stages Questionnaires (ASQ: SE-2®) are designed for children birth through age five. If your child is age six or more, please discuss his or her development with your child's health care provider, your local school district, or your child's teacher.

For more information or assistance, please contact:

Cornelia Singletary, Family Services Program Manager  

Phone: 252-985-4300

Email:  [email protected] 

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.