School Base Health Center Survey
The Lawrence County Health Department and Lawrence County School Districts are thinking about opening a School‐Based Health Center. Children attending schools within Lawrence County would be eligible to receive services at the School‐Based Health Center. Services might include immunizations, physical exams, care of minor illnesses (earaches, sore throats, cuts and bruises) and related family support services. The cost of services would be based on a sliding‐fee scale, and no one would be refused service because of inability to pay.
To help us plan for the School‐Based Health Center, we would like to ask a few questions about the health needs of your child. This information will help us decide what types of services and programs to offer at the Center. Your answers are completely confidential. You do not need to put your name anywhere on this form.
Thank you for your help.