School Based Health Clinic

Caring hearts, guiding health, for growing minds

What Is a School-Based Health Center?

A School-Based Health Center (SBHC) is a health clinic located right on a school campus. It provides primary, preventive, and urgent care services to help students stay healthy and ready to learn.

The Maryland School-Based Health Center Program supports these clinics so students and families can get care where it’s most convenient—at school. Our center is located on the campus of Indian Head Elementary School and is designed to increase access to health services for all Charles County Public Schools (CCPS) students.

Location

Indian Head Elementary School

4200 Indian Head Highway

Indian Head, MD 20640

How We Serve Students in Charles County

The School-Based Health Center at Indian Head Elementary offers a range of services during school hours. These services are available to CCPS students to help them stay healthy, in school, and ready to succeed.

Health Services We Provide

Who Is Eligible to Visit the School-Based Health Center (SBHC)?

All students enrolled in Charles County Public Schools are eligible to enroll in the School-Based Health Center and receive services. To enroll your child, simply complete the enrollment packet provided by the school and return it to the school nurse at Indian Head Elementary School.

What If My Child Already Has a Doctor?

The SBHC is not a replacement for your child’s primary care provider. Instead, it offers a convenient option for students to receive care for illnesses or minor health concerns during the school day. With your permission, SBHC staff can coordinate and share information with your child’s doctor to ensure continuity of care.

Why School-Based Health Centers Matter

School-based health centers help students stay healthier—and healthier students learn better. When students have easy access to care, they miss fewer school days, feel better, and can focus more on learning.

If you have questions or would like more information, please contact 301-934-7341. We look forward to supporting the health and well-being of every student we serve.

School Based Health Center Consent for Health Services and Treatment

Please download the consent form and complete all pages. Upload your completed consent form using the section below. 

Max. file size: 128 MB.

NOTICE OF PRIVACY PRACTICES

THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW CAREFULLY.

Introduction

The Charles County Department of Health (CCDOH) is committed to protecting your health information. CCDOH is required by law to maintain the privacy of Protected Health Information (PHI). PHI includes any identifiable information that we obtain from you or others that relate to your physical or mental health, the health care you have received, or payment for health care.

As required by law, this notice provides you with information about your rights and our legal duties and privacy practices with respect to the privacy of PHI. In order to provide treatment or to pay for your health care, CCDOH will ask for certain health information and that health information will be put into your record.

The record usually contains your symptoms, examination and test results, diagnoses, and treatment. That information, referred to as your health or medical record, may be used for a variety of purposes.

CCDOH and its Business Associates are required to follow the privacy practices described in this Notice, although CCDOH reserves the right to change our privacy practices and the terms of this Notice at any time.

You may request a copy of the new Notice from any CCDOH agency. This Notice is also available on our website at:
https://charlescountyhealth.org/notice-of-medical-practices/

Permitted Uses & Disclosures

CCDOH employees will only use your health information when doing their jobs. For uses beyond what CCDOH normally does, CCDOH must have your written authorization unless the law permits or requires it.

Uses and Disclosures Without Consent Relating to Treatment, Payment, or Health Care Operations
  • For treatment: CCDOH may use or share your health information to approve or coordinate treatment.
  • To obtain payment: CCDOH may use and share your health information to bill and collect payment for services.
  • For health care operations: CCDOH may use and share your health information to evaluate the quality of services or for audits.
Other Uses and Disclosures Required or Permitted by Law
  • Appointment reminders and program information
  • Disclosures required by law
  • Public health activities
  • Health oversight activities
  • Coroners, medical examiners, funeral directors, and organ donation
  • Research purposes under appropriate supervision
  • Averting a serious threat to health or safety
  • Abuse, neglect, or domestic violence reporting
  • Specific government functions
  • Family, friends, or others involved in your care
  • Worker’s compensation programs
  • Patient directories (if maintained)
  • Lawsuits, disputes, and claims
  • Law enforcement purposes
  • Business Associates performing permitted activities
  • Fundraising activities (limited contact information only)
Your Rights

You have the right to:

  • Request restrictions on uses and disclosures
  • Request confidential communications
  • Inspect and obtain copies of your health information
  • Request amendments to your health record
  • Require authorization for certain uses and disclosures
  • Receive an accounting of disclosures
  • Opt-out of fundraising communications and health information exchanges
  • Receive a paper or electronic copy of this notice
  • Receive notification of a breach of unsecured PHI
  • Receive protection of genetic information
  • Receive protection of mental health records
For More Information

This document is available in other languages and alternative formats. If you have questions, contact:

Charles County Department of Health
Phone: 301-609-6900

To Report a Problem About Our Privacy Practices

If you believe your privacy rights have been violated, you may file a complaint:

  • Charles County Department of Health, Division of Corporate Compliance
    Phone: 1-866-770-7175
  • U.S. Department of Health and Human Services, Office for Civil Rights

CCDOH will not retaliate against you for filing a complaint.

Effective Date: 11/10/2025

Acknowledgement of Receipt of This Notice
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FINANCIAL POLICY

Please read and sign the following financial guidelines for services provided by the Charles County Department of Health. Signature indicates understanding and consent.

Patients with health insurance should bring their insurance card to all visits. Please inform staff of any changes to insurance or address. Insurance on record will be billed for the services provided.

Patients with private health insurance (not Medicaid or Medicare) are responsible for all charges not covered by insurance. The patient is responsible for any balance not paid by insurance, including co-pays and deductibles.

Uninsured patients are required to apply for coverage (e.g., Medicaid, private health insurance, etc.) if eligible. The Charles County Department of Health (CCDOH) provides assistance with health insurance enrollment.

Patients who are uninsured and ineligible for Medicaid, Medicare, or private health insurance may apply to receive services through CCDOH’s income-based Sliding Fee Scale Program.

Applying for the Sliding Fee Scale Program requires proof of identity and income:

  1. Identification with address (e.g., driver’s license, utility bill, etc.)
  2. One of the following:
    • Pay stubs
    • 1040 tax form
    • Government benefits letter
    • Statement of wages on company letterhead
    • Unemployment stubs
    • Letter of reference from a charitable organization
    • Verification of no income support letter

A signed Financial Agreement is required for acceptance into the Sliding Fee Scale Program. Program eligibility will be determined annually.

Patients reserve the right to keep income and health insurance information confidential. However, patients who choose to keep this information confidential are ineligible for the Sliding Fee Scale Program and are responsible for the full cost of the health visit at the time of service.

Authorization to Release Information and Pay Insurance Benefits

I authorize CCDOH to share information about my health care with other providers involved in my care and with insurance companies for the purpose of making payments directly to CCDOH on my behalf.

Consent to Treatment

I wish to receive health care services from CCDOH. I understand that CCDOH health care professionals providing my care may determine that certain tests, treatments, or consultations are required to provide appropriate care.

I agree to the tests, treatments, and consultations deemed necessary.

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