MCS School-Based Health Interest Survey Question Title * 1. Are you Male or Female? Male Female Question Title * 2. How old are you? Question Title * 3. Do you think that you would enroll your child(ren) if there was a School-Based Health Center in Margaretville Central School? Yes No Question Title * 4. If ‘yes’, what service(s) do you think your child(ren) might use? (select all that apply) Medical services (acute visits, chronic condition visits, well visits, immunizations) Mental health services (anxiety, depression, adjustment disorders) Dietary counseling Preventative dental services (cleanings, sealants, fluoride treatments) Question Title * 5. Where does your child usually see a dentist? Within ½ hour drive over an hour drive Has not been seen recently Question Title * 6. Where was the last place that your child had a physical examination by a health care provider outside of school? Margaretville Community Clinic At school by the School Doctor Cooperstown or another Bassett site Non Bassett provider Question Title * 7. When your child has a medical appointment, typically, how long is your child out of school? 1-2 hours half day the whole day Question Title * 8. Has your child been seen in an Emergency Room or Urgent/Convenient Care in the last year? Yes No Question Title * 9. Does your child have a chronic medical condition (circle all that apply)? Asthma Overweight/obesity ADHD Anxiety/depression Other Question Title * 10. Does your child have health insurance? (SBHCs will see children whether or not they have insurance?) Yes No Question Title * 11. What would be the best way to provide you with information about a school-based health center? Live presentation at school Zoom presentation School Website School Facebook page Direct mailing Other Question Title * 12. If you answered "other" above, please explain below. Question Title * 13. Do you have any questions about a School-Based Health Center? (Please share below) Done