The purpose of this qualitative investigation was to understand the beliefs of parents and school personnel about involving secondary-age students with extensive support needs in their specialized health care procedures at school. Participants included parents, special education teachers, school nurses, one-to-one nurses, and paraprofessionals reporting on nine middle school, high school, and post-high school students for a total of 32 participants. Semi-structured interviews were conducted and then analyzed by case using an inductive coding approach. A synthesis of salient findings across groups generated four themes that describe beliefs about involving students in their specialized health care procedures. These were: (1) "student characteristics make it challenging"; (2) "must be safe"; (3) "working together is essential but difficult"; and (4) "involvement promotes well-being." Families and school personnel predominately valued student involvement in health care at school for perceived social-emotional benefits and potential positive adult outcomes but were unsure how to mitigate barriers to teaching students skills needed to participate in their health care. Implications discussed offer guidelines to enhance scientific and practitioner knowledge that promotes student involvement in health care at school for secondary-age students with extensive support needs.