The establishment of standard history-taking will be discussed and will include examples of such histories developed in the clinic. The development of a protocol for performing and recording physical examinations will also be described. Special tests, such as pulmonary function and sputum cytology, will then be discussed. The integration of medical data into a data base will also be discussed with examples taken from the program in Pittsburgh. Presentation of the problems of obtaining adequate early medical information leads to the conclusion that medical surveillance programs must be integrated with industrial hygiene surveillance. The use of exposure measures to make and implement preventive medical decisions is essential until medical science provides tests with enhanced sensitivity and specificity for use in early detection of workplace disease.