For people living with dementia (PLWD), decisions about driving safety extend beyond clinical risk to issues of life quality and social context. General practitioners (GPs) are required to assess patients’ fitness to drive (FtD), yet valid tools are limited. Commonly used tests may contribute to clinical judgement but lack face-validity for PLWD who may be less receptive to recommendations to stop driving. This presentation reports development of a dementia-specific off-road driver safety assessment for primary care. Case examples highlight challenges faced by GPs and PLWD that this new assessment addresses. A novel video-based hazard perception test (HPT) was developed for use in general practice, with emphasis on feasibility and face-validity. Our preliminary validation study provided evidence of criterion-related validity (i.e., experience-level performance differences) and internal consistency reliability. Feasibility, acceptability, and perceived usefulness were explored through post-test end-user interviews. Feedback from end-users – including PLWD and GPs who completed the assessment – highlights that (1) GPs experience practical and relational constraints when conducting FtD assessments in time-limited consultations, and (2) PLWD respond more positively to an assessment perceived as directly related to driving. Collectively, these examples suggest that perceived legitimacy of the assessment is critical not only to patient engagement, but also to GPs’ ability to use the tool confidently in difficult clinical conversations. A driver-specific, face-valid assessment with accompanying primary care resources may help address limitations of existing approaches by improving both usability for GPs and acceptability for PLWD. These early findings support further evaluation of the feasibility, acceptability and wider clinical utility of the assessment in primary care settings.