School Based Health Center Questionaire Question Title * 1. What important services should be offered for the students of Lowell School and their families? Medical services (such as check-ups and immunizations) Dental services Behavioral health/counseling services Other; if so, please list Question Title * 2. Do you need someone at the school to help link you to resources in the community around any of the following: Accessing Medicaid or Healthy Montana Kids Food support Housing support Utility support Financial counseling support Other; if so, please list Question Title * 3. Does your child have to take medicine every day? No Yes; if yes, would you like help with a treatment plan? No, I do not need help with a treatment plan Yes, I would like help with a treatment plan Question Title * 4. Does your child need a chronic healthcare plan if they have diabetes, asthma or another condition? No Yes If yes, diabetes is the chronic condition If yes, asthma is the chronic condition If yes, other chronic condition Question Title * 5. When would you prefer your child receive dental cleanings and services? During school hours After school hours Other Question Title * 6. Depression is very common in school aged children. Would you like our behavioral health team to offer individual, family or support group sessions? Individual Family Support Group No behavioral health services needed Question Title * 7. What hours of operation would you like to see the clinic open? Question Title * 8. Do you have a need for daycare while your family is accessing services at the clinic? Yes No Question Title * 9. What dream do you have for the school-based health center? Question Title * 10. Do you have a suggested name for the school-based health center? Done