The health-awareness program conducted by school nurses was an in-service program for elementary school teachers. Effects of the program on the teachers' referrals, school nurses' management of referrals, and pupils' absence patterns were studied. Four pairs of schools participated; one pair each for schools with predominantly white and Hispanic students and two pairs for mostly black students. The schools in each pair were matched by predominant enrollment of pupils' race or ethnicity and randomly assigned to the experimental or control group. Referrals for pupil health services form and Pupil's daily class attendance record were used as instruments. Results showed that (1) the program significantly increased referral rates, (2) in seven of the eight schools at least 50 percent of reported health problems remained unsolved by the end of the 1982–1983 school year, and (3) the program had little impact on absence patterns. Collaboration between teachers and nurses played a key role in the success of the health-awareness program.