Chronic pain is a prevalent complaint in primary care. The use of long-term opioids is frequently employed to treat chronic pain. Opioid misuse or abuse is a significant public health problem. Concerns for patient safety, improving patient assessment and documentation of response to therapy for chronic pain patients, and the desire to improve quality of care for chronic pain patients were the driving forces behind this project. The goal of this project was to introduce and implement evidence-based clinical guidelines for the care of chronic pain patients into practice at a small nurse managed primary care clinic for the poor. APS/AAPM chronic pain guidelines were chosen for their ease of use, applicability to the target population, cost effectiveness, and evidence-based approach to care. The guidelines were introduced to the staff in a morning training session after which they were utilized in clinical practice for a 16 week trial application. Staff compliance with the guidelines and specifically with the use of recommended patient assessment tools, informed consent/pain management (IC/PM) agreements, and urine drug testing (UDT) was measured. An anonymous chart review showed that compliance goals of 80% were met for the documentation outcomes (use of patient assessment tools and IC/PM agreements), but were not met for the monitoring outcomes (UDT). A key factor influencing the results, especially the monitoring results was noted to be small sample size. This project utilized validated patient assessment tools to consistently assess pain, evaluate response to therapy, and monitor aberrant drug-related behaviors in chronic pain patients. The UDT efforts identified a significant number of inappropriate results. Additional efforts are required to identify barriers and devise solutions in order to facilitate the long-term, efficient use of evidence-based clinical guidelines for chronic pain patients at Impact Christian Health Center.