The aim of the present study was to formally evaluate the effectiveness, professional appropriateness and acceptability of the extended role of the nurse practitioner at the Kirketon Road Centre (KRC) in Sydney, Australia. Data collection consisted of client and staff surveys and case file review by two assessors (one medical and one nursing). This paper will report on one section of this research, namely the case file review section of the study. Total study subjects were 1046 'at risk' youth, sex workers and injecting drug users attending KRC for their primary health care needs between September 1994 and April 1995. Nurse practitioners (NP) saw 613 of the clients who presented over this period. The majority of these clients were women (77.3%). The majority of NP consults were related to STD (51%), gynaecological (17%) and hepatitis (16%) issues. The results demonstrated that nurse practitioners were professionally appropriate in all aspects of expected 'best practice' in over 95% of consultations.