Woodbridge School District302-349-4539[email protected]400 Governors Ave.Greenwood, Delaware 19950Www.ececraiders.net
Weeks Premature (put "0" if not premature)
List others assisting with completion of the questionnaire
By giving my consent, I understand that ASQ screening results will be shared with:
· The Delaware Department of Education (DDOE) and the Division of Public Health (DPH) within Delaware Health and Social Services (DHSS) to better support my child.
· My child care program who is required by law to track completed developmental screenings to help better support my child.
· The Birth to Three Early Intervention Program (B23) or my school district of residence and/or school district where my child care is located because they review the screenings and help with next steps.
o I will be contacted with results via email, US mail, or phone call to assist with follow up.
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