The Newest Vital Sign (NVS) assesses health literacy in clinical settings. This exploratory study examined the feasibility of using the NVS as a self-administered questionnaire (SAQ) in a low-income, primary care setting. Adult hypertensive patients were recruited in 2011-2012 (n=238). Quantitative and qualitative analyses were conducted to examine potential issues with self-administration. Patients had low rates of adequate health literacy (28.4%). Only half of respondents completed the NVS (54.4%). Being Black, female, and having additional chronic illnesses increased the likelihood of being a partial responder as opposed to being a completer. Easier math problems and reading comprehension items were attempted in greater numbers by partial responders. Results indicate issues with interpretation and the need for better scoring instructions. Future studies that self-administer the NVS should consider slight modifications. The NVS provides important information about patients' health literacy and it is a valuable tool to assess patients' understanding of food labels.