Help Me Grow South Alabama
251-431-5100
[email protected]
P.O.Box 91068
Mobile, Alabama 36691

Welcome to the Ages and Atages Questionnaire with Help Me Grow Alabama!

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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, 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!



(put "0" if not premature)



We would like to send a copy of the scored questionnaire to your child health care provider. This is a free service, and allows you to work interactively with your health care provider so they can offer better care to your family. If you do not wish to receive this service please contact us at the information listed above and we will remove this permission from your file.

When filling out this questionnaire make sure that your child is well rested, fed and happy. If you have any questions please feel free to contact us at the information listed above. Thank you for your participation, and have fun!

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.