The Patient Service Core of the Southwestern Comprehensive Sickle Cell Center will develop and coordinate strategies for offering education, outreach, counseling, and testing. Educational efforts will be aimed at primary care physicians, other health care professionals, trainees, patients and their families, and the general public. The centerpiece of outreach activities will be the East Texas Sickle Cell Outreach and Case Management Program (ETSCP), which has served over 250 patients with sickle cell disease in rural East Texas since the late 1980's. Testing for sickle cell disease, other than newborn screening that is performed by the Texas Department of Health, will be coordinated by the hemoglobin diagnostic laboratory at Children's Medical Center of Dallas. Genetic counseling in a non-directive fashion for affected patients and their families will be centered in the medical institutions, whereas testing for sickle cell trait and provision of high quality education and counseling to those tested will be handled by the Sickle Cell Disease Association of Texas - Dallas Chapter, with which the proposed Center has developed a formal contractual relationship through its Genetic Education and Counseling Program. The activities in the Patient Service Core will be coordinated by the Patient Service Administrator, who will report to the Core and Center Director, Dr. George R. Buchanan. The other medical institutions in Oklahoma and Texas participating in the Center will conduct similar educational, outreach, testing, and counseling initiatives, albeit on a smaller scale.