Manchester, Connecticut

Manchester School Readiness

Screening Request

Child's Information:
    • First name:
    • Last name:
    • Date of Birth:
    • Gender:
    • Was child born more than 3 weeks premature?
    • Child lives with:
Parent or Guardian Information:
    • First name:
    • Last name:
    • Address:
    • Cell phone:
    • Email:
    • Language preferred:
Other Information:
    • Which screening would you like to do?
    • Who is requesting this screening?
    • Does the Parent or Guardian grant permission to do this screening?
    • Where would you like the screening to be sent (default is parent or guardian address)?
    • Where did you hear about this service?

Information will be provided to the Manchester School Readiness Council and the organization providing the screening will reach out to the family.
Please contact Caitlin McNamara at or (860)647-5269 for concerns or questions