Objectives: This study aimed to determine the extent to which complementary and alternative medicine (CAM) practitioners in Australia are trained in and use CAM and Western medical diagnostic techniques, and the influence this may have on their role as primary contact practitioners. Design: A 45-item questionnaire was mailed to members of the Australian Natural Therapists' Association and the Australian Traditional Medicine Society. Results: We received 617 responses (22%). Respondents reported high frequency of training in and use of Western case history taking, observation, taking blood pressure and pulses, palpation, postural assessment, orthopaedic testing, in addition to naturopathic case history taking, iris diagnosis, and face, tongue, and nail diagnosis. We found a significant relationship between the confidence practitioners had in identifying clients requiring referral and their training in these areas. Conclusions: Despite the reported high frequency of training in and use of Western medical and CAM diagnostic techniques, 32% of respondents reported a lack of confidence in identifying patients requiring referral. This could compromise the safety of clients and the effectiveness of practice.