People with serious and persistent mental illness (SPMI) are at higher risk for cardiovascular and metabolic abnormalities than the general population. Despite this, those with SPMI are less likely to have corresponding physiological markers, such as glycosylated hemoglobin (HbA1c) and lipids, recorded. Behavioral health nurses are well situated to bridge this gap and provide both mental and physical health support. Evidence suggests blood work collected by behavioral health nurses, rather than coordinating with an external facility, can reduce delays and costs of laboratory monitoring. Although within their scope of practice, a lack of training and organizational support has prevented behavioral health nurses performing phlebotomy. The purpose of this quality improvement project was to create and train behavioral health nurses working in a local community mental health clinic in phlebotomy.