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ABSTRACT: Evaluations of the quality of School-Based Health Center (SBHC) care, both satisfaction and outcomes, have been developed by several state SBHC initiatives. However, few of these patient satisfaction surveys have been rigorously evaluated. An adolescent patient satisfaction based on a grading rubric familiar to the adolescents was developed and used to assess care at a nurse-managed teen health center. Satisfaction data on 190 encounters were collected in one SBHC using a report card rubric. The adolescent patients represented grades 6th through 8th, and were almost equally distributed between girls (55.9%) and boys (44.1%). This SBHC was a part of a university consortium of nurse-managed centers. Results demonstrated high satisfaction (approximately 3.7 out of 4) with care using a reliable tool (a = .84) designed for adolescents, which incorporated a grading rubric for the evaluation criteria. The nurse practitioner received high marks for listening to the students and treating the students with respect. Yet, statistical differences by grade level were found. The satisfaction tool was found to be reliable (alpha = .84) and consistent with adolescent's perspectives on satisfaction with health care. The study is the first published report that specifically examined student satisfaction with care in a nurse-managed SBHC. Overall satisfaction with care received high "grades" from both first time and repeat users, and from boys and girls.Pediatric nursing 03/2007; 33(2):103-9.