This is the last article in a four-part series that presents an updated protocol for selective longitudinal health maintenance of asymptomatic adults. Nine metabolic, behavioral, and miscellaneous conditions are reviewed with reference to six generally accepted screening criteria. A recommendation is made for each condition and is compared, when appropriate, with the recommendations of the Canadian Task Force on the Periodic Health Examination. The recommendations for all 30 conditions reviewed in this four-part series are combined into a practical health maintenance flow sheet for use by primary care physicians.