Measures of physical fitness are important indicators of positive health that could be used to improve overall patient management. Unfortunately due to time, space, and financial limitations, such measures are often unavailable to health care providers. PURPOSE: To describe the process of the first two phases of developing a Self Reported Fitness (SRFit) survey intended to estimate fitness in adults >40 years of age across 5 domains; 1) muscular strength and endurance, 2) cardiovascular fitness, 3) flexibility, 4) BMI, and 5) body composition. METHODS: SRFit items were developed based on the previously validated Rikili and Jones Senior Fitness Test battery of physical tests. After several face-to-face interviews with patients to refine SRFit item wording, fitness tests and the SRFit survey were administered to 48 subjects (Phase 1). SRFit items with incomplete data or low concurrent criterion validity (Pearson r<0.25) relative to analogous fitness tests were revised. In Phase 2, the fitness tests and revised SRFit survey was administered to a new sample of 59 subjects. To assess criterion validity across a range of fitness levels, one-half of the subjects were recruited from a fitness facility and one-half from a safety net community health center. RESULTS: There were 30 males and 29 females and 17 African-American and 42 white participants. Mean age was 59±7.9 yr and mean BMI was 30.1±8.3 kg/m2. Significant correlations were found between SRFit items and fitness test scores in the following domains: Lower body strength and endurance (number of chair stands; r=0.57, 0.57, 0.73; p<0.001); Upper body strength and endurance (number of arm curls; r=0.49, 0.50, 0.56; p<0.001); Cardiovascular fitness - Walk Test (r=0.43, 0.69, 0.65; p<0.001); Lower body flexibility - Sit and Reach (r = 0.42, 0.53, 0.35, 0.49; p<0.001); Left upper body flexibility - Back Scratch (r=0.53, 0.48, 0.50, 0.48, 0.39, 0.53; p<0.001); Right upper body flexibility - Back Scratch (r=0.61, 0.39, 0.42, 0.51, 0.38, 0.55; p<0.001), BMI (r=0.70, 0.72, 0.61; p<0.001); and percent body fat (r=0.79, 0.81, 0.73; p<0.001). CONCLUSION: At least 3 SRFit items in each fitness domain were correlated with the analogous physical fitness tests. Phase 3 of this project will recruit 200 subjects and seek to further establish validity and reliability of the SRFit survey.