A functional approach to language teaching begins with knowing how students intend to use the foreign language for specific purposes and in specific situations. Instructors of medical Spanish can begin by determining the specific language functions that their students must be able to express when communicating with Hispanic patients, by means of a survey taken during the first class meeting. Such a questionnaire would request information about: the students (including their language background, travel, career plans, medical specialization, reasons for enrolling in the course, and most needed Spanish communication skills) and most-needed language categories, such as socialization, maintaining close relationships, influencing people's actions, making judgments, and action in specific medical situations. Survey results determine the appropriate classroom language exercises and activities. Materials can focus on a unifying theme such as serving patients in emergency situations, physical examinations, pre- and post-natal care, and nutritional counseling. The language practice provided should be both realistic and enjoyable, and specific techniques can be incorporated. These include teaching the vocabulary and structures specified most on the questionnaire, teaching the expression of past actions, using Total Physical Response, using students-centered input, using pictures creatively, and using paired interviews. (MSE)