Glencoe Regional Health
320-864-3121
1805 Hennepin Ave N
Glencoe, Minnesota 55336
www.grhsonline.org

Welcome to our child development screening program!

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Because your child's first 5 years of life are so important, we want to help you provide the best start for your child. You've been invited to participate in the Ages & Stages Questionnaires, Third Edition (ASQ-3), to help you keep track of your child's development. The questionnaire may be provided every 2-, 4- or 6-month period. You will be asked to answer questions about some things your child can and cannot do. The questionnaire includes questions about your child's communication, gross motor, fine motor, problem solving, and personal social skills.

Please enter your child's birth date and the number of weeks he or she was born premature below to start the screening. 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.

We look forward to your participation in ASQ-3!



(put "0" if not premature)


Once you click submit, you will be asked to print the questionnaire, complete it and then enter your results online. Please note, if you do not have a printer, you may proceed directly to "Step 3" and complete the questionnaire online without printing it.
 
By clicking submit, I agree I have read the above information about the Ages & Stages Questionnaires and wish to have my child(ren) participate. I agree to complete the questionnaires about my child’s social and emotional development to the best of my knowledge and ability and submit the information through the online questionnaire completion system.

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.