The National Response Plan (NRP) establishes the framework for the nation's response to major disasters. We offer seven recommendations related to surveillance of workers who respond to events under the NRP. These recommendations address the rationale for and principles of medical surveillance in the context of large-scale disasters and the NRP; means of identifying and registering the populations that should be included in surveillance activities; the role of exposure assessment in medical surveillance; behavioral health issues; and principles regarding the communication and use of surveillance data.