The psychometric considerations and challenges associated with including constructed response items on tests are discussed along with how these issues affect the form assembly specifications for mixed-format exams. Reliability and validity, security and fairness, pretesting, content and skills coverage, test length and timing, weights, statistical specifications, and equating concerns are all discussed. Practical suggestions for dealing with these concerns in the form assembly specifications are presented. Advanced Placement Program® (AP®) Exams are used as examples throughout, as most all of these large-scale standardized exams contain both multiple-choice and constructed response items.