A recommendation from a physician is the most influential factor in determining whether a patient is screened for colorectal cancer. While the vast majority of primary care physicians report that they screen for colorectal cancer, many patients do not receive the recommendation they need. Evidence-based strategies can help the physician ensure that every appropriate patient leaves the office with the needed recommendation. Choosing an office system that can be implemented by the physician or office staff can fuel efforts to achieve higher screening rates. Reminder systems, tracking systems, communication strategies, and policies that reinforce use of evidence-based guidelines may contribute.