Make a Referral:
Provider Referral Forms:
For Parents and Service Providers:
For Medical and Community Providers (Universal referral form):
Child Development Screening: A screening designed to help parents check their child’s developmental milestones.
Please note: This is a confidential, free online tool that is part of an ongoing research study. No personally identifying information is required to check your child’s development using this site. The completed questionnaire(s) and results are not automatically sent to any other provider or practitioner. If you do want to share the results with an Early Intervention Provider, your child’s day care person, your pediatrician or other, you can easily “forward” to anyone from your own email at your convenience.
If you would like to send your ASQ results to the Multnomah County EI/ECSE program, please download them to your desktop and email them to us at: email@example.com