A 'health-literate organisation' recognises that miscommunication is very common and can negatively affect consumer care and outcomes, and makes it easier for people to navigate, understand, and use health information and services. This paper reports on the First Impressions Activities conducted by consumers to assess aspects of the literacy environment of a rural health service. The First Impressions Activities consists of three tools to assist health services to begin to consider some of the characteristics of their organisation that help and hinder a consumer's ability to physically navigate their way to and about the health service. The results show that navigation to and within the rural health service was made more complex due to lack of information, difficulty finding information, inconsistent terminology used in signage, missing signage, signage obscured by foliage, and incorrect signage. What is known about the topic? The environment of a health service represents the health literacy expectations, preferences and skills of those providing health information and services. What does this paper add? This case study offers insight into the literacy demands placed on consumers, as well as an effective tool to assess aspects of those health literacy demands. What are the implications for practitioners? Health services can use the First Impressions Activities to actively engage consumers in the assessment of their first impressions of the health service shaped by a phone call, a visit to the website and a walk to the entrance and to different destinations. These activities can assist a health service to begin to examine the navigation of the service through 'fresh eyes', using a structured process to identify ways to decrease the health literacy demands on consumers.