Background: As the number of cancer survivors grows, new models of survivorship care are being implemented internationally, but there is limited evaluation of them to date. This retrospective review assesses the concordance of care provided to adult-onset cancer survivors in nurse practitioner (NP)-led clinics with Institute of Medicine (IOM) guidelines for comprehensive survivorship care. Methods: Records from three survivorship clinics were reviewed to determine frequency of surveillance for recurrence (SR), screening for second cancers, symptom management (physical, psychological), health promotion education (alcohol, tobacco, cholesterol, bone density screenings; discussions on diet, exercise), and care coordination (provision of care plan). Visit length and payor mix were also assessed. Data were characterized using descriptive statistics. Results: From 4Q 2011 - 3Q 2013, 9052 unique visits occurred within the three clinics; 210 breast, 208 prostate, and 204 colorectal visits were randomly selected from these visits for review. All breast patients underwent SR, and 99% received screenings for new primary cancers. Frequency of discussion of designated health promotion activities ranged from 83-100%; 91% of visits discussed physical symptoms, and 93% discussed psychological symptoms. In prostate, 100% of patients underwent SR; 97% were screened for new primaries. Health promotion frequency ranged from 70-97%, depending on activity, and 89% of visits discussed physical/psychological symptoms. In colorectal, all patients underwent a colonoscopy for SR; 97% had a CEA test. Of female colorectal patients, 97% had a mammogram, 96% had a Pap smear; 83% of male patients had a PSA test. Health promotion activities ranged from 69-100%, and 93-97% of visits discussed symptoms. Provision of care plans varied substantially among clinics, due in part to staffing and clinical systems issues: 36% prostate, 70% breast, and 92% colorectal. Conclusions: These findings suggest the success of NP-led clinics in providing quality survivorship care in accordance with IOM standards. While IOM guidelines are not considered a final authority, they provide normative standards. This assessment is an important step in evaluating survivorship outcomes.