ABSTRACTBetter problem identification and improved access to community health care were the result of changes made during the past three years in a traditional urban high school health service. The first change included training the nurse to become a pediatric nurse practitioner and adding a full‐time health aide. The other change included the use of clinic management forms developed by the nurse practitioner/health aide team to be used for three common student complaints: headache, stomachache and upper respiratory symptoms. Our experience indicates that out‐of‐school referrals for medical care doubled, and more students referred received care after these changes were instituted. The high school pediatric nurse practitioner counsels students in understanding their health problems and in making decisions about their health care. She also coordinates educational and health resources and provides psychosocial support for stu