9 months 0 days through 9 months 30 days 9Month Questionnaire

Please provide the following information. Use black or blue ink only and print legibly when completing this form.

On the following pages are questions about activities babies may do.  Your baby may have already done some of the activities described here, and there may be some your baby has not begun doing yet. For each item, please fill in the box that indicates whether your baby is doing the activity regularly, sometimes, or not yet.

1. Try each activity with your baby before marking a response.

2. Make completing this questionaire a game that is fun for you and your baby.

3. Make sure your baby is rested and fed.

 

Ages & Stages Questionnaires®, Third Edition (ASQ-3™),Squires & Bricker © 2009 Paul H. Brookes Publishing Co. All rights reserved.