School-based health centers (SBHCs) are a model of healthcare where services are delivered in clinics on school campuses (Kjolhede et al., 2021; Harris et al., 2016), with research indicating the delivery model has several educational benefits (Kjolhede et al., 2012; Arenson et al., 2019; Knop et al., 2016). Research findings supporting the use of SBHC; yet, these centers report low utilization of services. Teachers were identified as a main source of referral for students to SBHCs due to the amount of time teachers spend with students (Wade et al. 2008), connecting them as a driving source of inquiry for increasing further use of services for SBHCs. This study explores how to increase the use of services for a site-specific SBHC from the perspective of teachers and school administrators. The researcher used a case study methodology with data collected through eight semi-structured interviews with teachers and administrators at the research site. The findings report several themes contributing to underutilizing services for the SBHC: lack of information and communication on processes and procedures, under-developed relationships between SBHC and teachers and administrators, absence of teacher empowerment, and need for teacher and parent engagement with the SBHC. The findings were transferable with other SBHC studies; a formative concept of empowerment is unique to this study. compared to the three data sources used to create codes for the literature. Based on the findings, three recommendations were generated to improve the problem of practice: the research site should develop a formalized process for its SBHC and share information on the resources and processes concerning the SBHC with teachers; cultivate trust and develop meaningful relationships between teachers and the SBHC; and, empower teachers, structurally with policy development and psychologically with creating meaning on the impact and importance of referring students to the SBHC, within SoE. The implications of this study concerning SBHCs and increasing use of services were in alignment and transferable to previous findings; however, most of the literature discusses the importance of relationships with teachers and SBHC staff, but few studies identify empowerment as a strategy to increase the use of services for SBHCs. Empowerment was a seminal concept revealed in this study regarding elementary education in the field of preventative healthcare services. Additional studies are needed to explore what elements and activities of empowerment had the greatest impact on referral of services for SBHCs. In closing, information, trust, communication, and teacher empowerment are elements for consideration for increasing the use of services for SBHCs. [The dissertation citations contained here are published with the permission of ProQuest LLC. Further reproduction is prohibited without permission. Copies of dissertations may be obtained by Telephone (800) 1-800-521-0600. Web page: http://bibliotheek.ehb.be:2222/en-US/products/dissertations/individuals.shtml.]