Pediatric Associates of Northern CO
970-484-4871
[email protected]
1330 Oakridge Dr Ste 100
Fort Collins, Colorado 80525

Pediatric Associates of Northern Colorado has know gone electronic for our ASQ questioners.

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!

Child Date of Birth

Month Day Year

Weeks Premature
(put "0" if not premature)

Screening Date

I am screening my child today (11-25-2024) I screened my child and am entering in the responses to a previous screening

List others assisting with completion of the questionnaire

Thank you for participation in your childs 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.

Pediatric Associates of Northern CO970-484-4871[email protected]1330 Oakridge Dr Ste 100Fort Collins, Colorado 80525

Pediatric Associates of Northern Colorado has know gone electronic for our ASQ questioners.

Pediatric Associates of Northern CO
970-484-4871
[email protected]
1330 Oakridge Dr Ste 100
Fort Collins, Colorado 80525