FCSS
Petra DeBow, Program Manager
403-795-3382
[email protected]
www.fcss.ca

Welcome to the Ages & Stages with FCSS.

To take part in the Ages and Stages check-up for your child:

1) Fill out the questionnaires about your child's development

2) Return the completed forms through the Ages and Stages online system.

 

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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: Social-Emotional, Second Edition (ASQ:SE-2) to help you keep track of your child's social and emotional development. The questionnaire may be provided for use at 2, 6, 12, 18, 24, 30, 36, 48, or 60 months of age. You will be asked to answer questions about some of your child's behaviors. The questionnaire includes questions about your child's ability to calm down, take direction and follow rules, communicate, perform daily activities (e.g., eating, sleeping), act independently, demonstrate feelings, and interact with others.

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:SE-2!



(put "0" if not premature)



IMPORTANT! By filling out the form: 

1) You give permission to have your area FCSS staff go through the results and provide feedback to you, 

2) You give permission to have your area FCSS staff inform you when the next questionnaire is to be completed.

Note: FCSS can offer follow-up services to families in the Barnwell, Barons, Coaldale, Coalhurst, Lethbridge County, County of Warner, Coutts, Milk River, M.D. of Taber, Nobleford, Picture Butte, Raymond, Stirling, Taber Vauxhall, Warner areas.  If you live outside our area pelase contact your local Public Health office.

Barons-Eureka-Warner Family and Community Support Services (FCSS) is a public body and therefore the personal information collected using this form and any attachments related to program and service delivery is authorized under the authority of section 33 (c) of the Freedom of Information and Protection of Privacy Act and is protected by the privacy provisions of the Act for the purpose of providing programs and services.  The information will be used for service delivery, program evaluation and reporting purposes, and may only be disclosed in accordance to the Act.  For further information, please contact the FOIP Coordinator at 403-405-4466 or [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.