Occupational and Environmental Health Nurses (OHNs) are focused on the promotion, preservation, and maintenance of worker and worksite health, safety, and well-being, within the confines of the work environment. In many settings this is best accomplished with the development of a dedicated Occupational and Environmental Health and Safety Service (OHSS). Several potential models are available within which to deliver these services, depending on the needs of the population served. Deciding to establish such a program, and choosing the most appropriate model, requires careful thought, planning, decision-making, resources, and commitment. This brief guide is designed to outline the requirements, processes, decision points, and resources the OHN will find beneficial when considering the establishment of an OHSS.