The individual cancer service lines at the Abramson Cancer Center at Penn Medicine were delegated the responsibility of creating treatment guidelines for the entire health system during the COVID-19 pandemic. The purpose of these guidelines is to provide direction during the pandemic for rational Head and Neck Cancer management and achieve a medically and ethically appropriate balance of risks and benefits. Our goal in sharing the guidelines are three-fold. First, it may be useful to share the process of developing the guidelines and achieving consensus in a multi-hospital tertiary care system. Second, we would like to share our fundamental principles governing the guideline development process. Lastly, the guidelines themselves may be useful for Head and Neck Oncology services at other institutions to consider as they develop their own approaches.