Background: From a range of perspectives, scholars have demonstrated the value of school-based health centers (SBHCs) in recent decades, but few studies have examined the logistics of establishing SBHCs. Methods: Semi-structured interviews were conducted with 9 hospital and 6 school employees involved in a network of SBHCs. After common themes were identified, cluster analysis was performed. Finally, quotes were identified within each thematic cluster for further qualitative analysis. Results: The most prominent themes were (1) differences in physical space (between schools and clinical settings), (2) collaboration and communication, and (3) privacy and compliance. Implications For School Health Policy, Practice, and Equity: This study points to several high yield considerations for the practice of SBHCs. First, we identified three distinct needs: (1) clear funding streams for construction costs for health services on school grounds, (2) improved understanding of SBHC space needs, and (3) blueprints for collaborating within SBHCs. Second, this study points to a future in which new-build and renovated schools should include space for SBHCs. Conclusions: This qualitative thematic analysis provides a picture of health and educational professionals engaged in creative, collaborative, and adaptive work to meet children's health care needs within SBHCs, but also highlights the challenges of navigating physical space, compliance, and collaboration within SBHCs.