A community readiness survey for coalitions to address the growing epidemic of prescription opioid misuse was developed in this four-part study. A total of 70 coalition members participated. 1) We conducted 30-minute phone interviews with coalition members (n = 30) and a literature review to develop an item list. 2) Coalition members rated these 60 items for three criteria: importance, confidence in own answer, confidence in others' answer. 3) Highly rated items were included in a revised survey that was tested with coalition members (n = 10) using in-person cognitive interviewing to assess how coalition members were interpreting the questions. 4) Lastly, pre-testing and satisfaction testing with additional coalition members (n = 30). Most (83%) of the respondents reported positive overall impressions of the survey.