A pediatric gastroenterology clinic found patients with celiac disease (CD) reporting exacerbations of CD related symptoms. There is no cure and treatment for CD is a gluten free diet with routine follow-up care per national guidelines. The goal of this project was to identify adherence to national guidelines for CD follow-up care by conducting a medical chart audit. Variables such as ?RD Referral? followed national guidelines while others, including ?Biopsy Confirmation? did not. This project highlighted strengths and areas for improvement, while generating data for future PDSA cycles.