Intended as a guide in the development of a program of health services for migrant children, this operations manual designed by the State of Washington presents definitions, operational procedures, standards by which quality uniform physical examinations and linkage to health care systems can be established, and forms to be used in the program. Washington's program, which will build over the next five years, is predicated on the cooperative efforts of schools, Rural Health Clinics, State and local health agencies, and the interest of key professional people from medicine and education. The Migrant Education staff has structured the formal relationship between schools, Rural Health Clinics, and the County Health Departments so children and their parents can be included in already existing health care delivery systems. The relationship between schools, clinics, and the migrant education program is established by a written agreement. The schools identify the children, provide initial screening, and complete Migrant Student Record Transfer System records. The clinics, private physicians, and a mobile van team provide physical examinations and related laboratory work. (Author/CM)