We report the results of an on-site study of PV screening for 107 children seen in 28 pediatric practices. Participating practices were 54% group; 21% HMO; 18% solo; 8% other; all physicians were pediatricians. On-site evaluations included physician vaccine practice survey, direct screening practice observation, screening tool review, patient interview, and patient record review. Ability to administer enhanced inactivated poliovirus vaccine(e-IPV) or oral poliovirus vaccine (OPV) was reported by 82% of practices. All practices used screening: 71% direct patient query (active), 29% distribution of printed information (passive). Printed screening tools were prepared by national/local health agencies. Vaccine risk, consent process, immunocompromise and travel queries were most often included in screening tools; household immunization, occupational or childcare setting histories were least included. Screening documentation in the medical record was noted for 79% of children. On direct interview, 10/107 children reported an e-IPV indication not identified at practice screening; all received OPV. In our study, PV screening was prevalent but appeared inadequate (9% of observed children reported a missed e-IPV indication). Our study suggests that PV educational efforts are needed for this urban center, which may not significantly differ from other urban centers. Recent discussions of changes to the US PV schedule afford an opportunity for healthcare agencies to enhance PV educational efforts and improve screening tools nationwide.