Effective communication with adolescents in a school-based health care setting is critical for ensuring their engagement, understanding, and compliance with medical advice, which can ultimately lead to better health outcomes. This chapter explores the unique challenges and strategies involved in communicating with this age group, specifically in a school-based setting, highlighting the importance of establishing confidentiality, building trust, demonstrating respect, and providing age-appropriate information. Through a review of current literature and best practices, the chapter identifies key tools such as psychosocial screenings and motivational interviewing. By adopting these practices, healthcare providers can foster a more effective and collaborative relationship with their adolescent patients in the school health setting, thereby improving the overall quality of care.