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 and Stages Questionnaires are being offered by Help Me Grow Washtenaw. Your child's results are confidential.

I give EMU Children's Institute permission to read my child’s screening results and contact me regarding any future supports or resources that would be helpful to giving my child a great start. I also give permission to use my child’s score results in a compiled list to show county data results. The compiled list would not identify my child using his/her name, address, or other specific identifying information.

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.