Maintaining student health, safety, and welfare is a primary goal for any K-12 school system. If a child becomes sick, is injured, or seems in any other way incapacitated at school, it is the understood responsibility that the school will provide care and, if necessary, contact the parents and direct the child to outside treatment. Beyond that basic level of care, over the past 50 years has grown a larger commitment addressing professional care for students as they grow, including dental, visual, dietary, hormonal, and mental health--especially for disadvantaged children, in both urban and rural communities. Some school districts also extend care, at various levels, to student-age children not at that school or in school at all, people who work at the school, the family of students, and the general community. This paper addresses the key elements for designing school health centers, the emergence of school-based health clinics and the minimum requirements these facilities should have, and the basic principles to remember when designing school health centers. The paper's focus concerns the nurse's office and the school-based health clinic. Additionally highlighted are the types of school health centers and their importance. [This is an updated version of ED446424 (published in 2000).]