While domestic violence in rural areas is not different in kind or incidence from that found in urban areas of the country, rural women face unique difficulties in accessing health and social services when they experience abuse. We present an overview of rural life and the difficulties rural women face in accessing health care and other services. We describe the network of family planning clinics and domestic violence advocacy programs in western Pennsylvania and a pilot project designed to implement routine screening for domestic violence in family planning clinics in rural Pennsylvania. We report on changes in the staff's practice of and comfort with screening and making referrals during the initial six months of the program. Finally, we report on a partnership between the clinic and the domestic violence advocacy program in one county as a model for meeting the needs of rural women who experience abuse. This research supports recommendations that assessment and interventions for abuse be incorporated into rural health care systems.