Salida Health Center
719-530-2022
550 W Hwy 50
Salida, Colorado 81201

Welcome to our ASQ Online screening program!

Please fill out both ASQ and ASQ-SE prior to your child's wellness visit. 



(put "0" if not premature)



I have read the provided information about the Ages & Stages questionnaires, and I wish to have my child participate in the online screening program. I will fill out the questionnaire about my child's development and promptly submit the completed questionnaire through this Family Access 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.