Weeks Premature
(put "0" if not premature)

List others assisting with completion of the questionnaire

For ASQ:SE-2™ English

List others assisting with completion of the questionnaire

The Ages & Stages Questionnaires (ASQ-3) 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.

Participant demographic information is required for our program by the Children's Board of Hillsborough County to better serve you. Identifying information will remain confidential.

By clicking submit, you acknowledge that you have read the provided information about the Ages & Stages Questionnaires (ASQ-3), will complete the questionnaires regarding your child’s development and will return the completed questionnaires via the online questionnaire completion system.

You also agree to receive information from The Early Childhood Council of Hillsborough County, Inc. relative to the results of the screening as well as periodic information about our work.

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.