Weeks Premature
(put "0" if not premature)

List others assisting with completion of the questionnaire

For ASQ-3™ English

List others assisting with completion of the questionnaire

Personal information is collected in accordance with section 3 of the Municipal Government Act and section 33 (c) of the Freedom of Information and Protection of Privacy Act (FOIP) and is protected by FOIP. It is used by Strathcona County Family Resource Network to score the Ages & Stages Questionnaire results and report this information back to the child's parent. Aggregate information is reported to program funders; no individual information is provided. If you have any questions about the collection and use of your personal information contact the Manager, Family Resource and Supports, Strathcona County at 780-464-4044.

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