Building a patient navigation program is a multistep process. Most of the processes are comparable whether the program is based in a clinical or community setting. For any program to succeed, it needs planning, administrative support, adequate resources, and policies and procedures that utilize evidence-based methods. Important to the process of planning is comprehensive needs assessment, program design, identification of program champions, and ongoing quality improvement. Questions to consider and sample tools for assessment are included. An extended case example of the evolution of an American Indian patient navigation program is provided.