The Division of Medicaid & Medical Assistance provides Medicaid coverage to severely disabled children who do not qualify for Supplemental Security Income (SSI) or other Medicaid qualifying programs because of their parents’ income and/or resources.

Welcome to the Ages & Stages Questionnaire (ASQ)

When you’re ready, you will be redirected to the official Ages & Stages website to complete the questionnaire. 

Be sure to select the first option.

“I am completing both the ASQ-3TM and ASQ:SE-2TM questionnaires.”

Both the ASQ-3 and the ASQ:SE-2 must be completed in order to submit your referral.