You are on the Ages & Stages Questionnaire (“ASQ”) website hosted by Brookes Publishing Co., Inc. (“Brookes”).
Your decision to enter information into the ASQ website is strictly voluntary. You are not legally required to furnish any of the information requested. You have the option of enrolling in the Follow Along Program using paper forms instead of the ASQ website.
If you choose to use the online ASQ, the ASQ website will ask you to enter information about you and your family (collectively, “you”) to ensure you receive appropriate services. This information is classified as private data under the Minnesota Government Data Practices Act, Minn. Stat. Chap. 13. Data related to you and the services you receive will be maintained in the ASQ website and will be transferred to Dakota County Public Health’s records.
Purpose and use of the requested data
For the purpose of enrollment into the Follow Along Program, you will be asked to provide information about yourself and your child(ren) that may include your age, health issues during pregnancy, birthing experience, use of tobacco, drugs and alcohol, your child’s gender, birth weight, gestational age, birth experience, health concerns, race/ethnicity, health insurance, and the language the child speaks. If you choose to participate in the Follow Along Program, we will periodically ask for information about your child’s overall development, including your child’s health, communication, physical, mental and social development and behavior. We will also periodically ask you for updates to information you provided at enrollment. This program uses this information to determine your health care needs; to develop a plan for you and your family; provide information about alternative services available in your community; prepare reports and evaluation studies; evaluate and audit programs; and other purposes specifically authorized by you.
Consequences of providing or not providing information
You do not have to provide the requested information to Brookes or the Dakota County Public Health staff. If you choose not to provide information on the ASQ website, the Dakota County Public Health staff will not enroll your child in the Follow Along Program through the ASQ website, and will instead offer you the option to enroll in the Follow Along Program by filling out a paper form of the ASQ. Please know if you decide not to use the ASQ website to participate in the Follow Along program, your decision will not affect your eligibility for the Follow Along Program or any services you may already be receiving from Dakota County Public Health.
Should you decide to use the online ASQ, the information you provide to the Dakota County Public Health Department will not be released to anyone without your consent, unless otherwise authorized by law or court order. In addition, the private data about you and your children will be shared with the Minnesota Department of Health for the purposes of creating summary and evaluation data on the Follow Along program.
If you are a minor, you have the right to request that private data about you be kept from your parents. You must make this request in writing and explain why you wish this data to be withheld and what you expect the consequences of sharing the data with your parents would be. If Dakota County agrees that withholding the information from your parents is in your best interests, the data will not be shown to your parents, as long as withholding data is consistent with state and federal law.