Many public fitness centers offer special exercise programs for older adults and persons with stable heart disease. To evaluate emergency procedures and education of staff at these facilites, we sent a written survey to 204 randomly chosen fitness centers throughout Massachusetts (54% response rate, n=110). Results showed 72 facilities (65%) offered programs for the elderly and/or CAD. Twenty-four facilities (33%) stated less than half of their fitness staff had a bachelors degree in exercise science or a related field, while at 4 centers (5%) no staff had a degree. Moreover, 19 facilities (26%) stated less than half of their fitness instructors had some type of fitness certification. All staff was certified in basic cardiac life support (BCLS) at 67 (93%) of facilities while emergency training was part of staff orientation at 64 (89%) of centers. Emergency drills were practiced or reviewed routinely(i.e. >2x/yr) at only 12 (17%) of facilities, while 24 (33%) never reviewed their procedures. Medical screening using a health history questionnaire was said to be “rarely used” at 10 (14%) of these facilities. Sixteen(22%) stated they would allow an individual who has a known medical condition such as heart disease or diabetes to exercise in their facility without obtaining physician consent (although 12 (17%) would require a waiver from the client). A defibrillator was on site at only 3 centers (4%), while some type of medical emergency requiring an ambulance occurred at 44 (61%) facilities in the last yr and at 55 (76%) during the last 5 yrs. We conclude fitness centers offering special programs for the elderly and persons with heart disease have a considerably high percentage of staff without a fitness degree or certification, although most are certified in BCLS. Also, emergency drills and entry screening are not routinely practiced at many of these facilities and exercise is often permitted without obtaining physician consent. Facilities who offer special programs for these higher risk individuals must work toward providing an optimal environment to ensure the safety of their clients.