Kodak's instructions (link in post #47) illustrate the complications involved when using a gray card. The first complication is trying to estimate an angle that is 1/3 of the total angle between the subject and the primary light source. Some people have "perfect pitch" -- the ability to accurately identify certain audio frequencies. What I do not have is "perfect protractor" -- the ability to accurately visualize angles in 3D space. (Probably why I am no good with a pool cue.)
And then there are the rules for when to adjust the gray card reading.
The first adjustment rule is: "For subjects of normal reflectance, increase the indicated exposure by 1⁄2 stop." I've never really understood the rationale behind this suggestion. I assume the 1/2-stop additional exposure is necessary because 18% is not the correct reflectance to represent the average reflectance of a normal scene?
Due to the high cost of Kodak brand gray cards, I was tempted into buying some Delta brand gray cards at a much lower cost. Delta advertises the same specifications as Kodak, 18% gray, plus or minus 1%. However the Delta instructions are slightly different. Delta says the correct angle is "halfway between the main light and the camera." And Delta does not suggest adding 1/2 stop exposure to normal subjects.
I still carry a Kodak gray card, but I rarely use it. For most subjects and conditions, my built-in camera meters are adequate - if used with good judgement. If I want a second opinion in difficult lighting, then an incident meter does pretty much the same thing as a gray card, and it is less fussy to use.