Study Design Delphi panel and cohort study. Objective Develop and refine a condition-specific patient reported outcome known as the Ankle-Fracture Outcome of Rehabilitation Measure (A-FORM); and examine its psychometric properties including factor structure, reliability, and validity by assessing item fit with the Rasch model. Background To our knowledge, there is no ankle-fracture specific patient reported outcome with robust content foundation. Methods A 2 stage research design was implemented. First, a Delphi panel including patients and health professionals was used for item development and wording refinement. Second, a cohort study (n=45) with 2 assessment points was undertaken to permit preliminary maximum likelihood exploratory factor analysis then Rasch analysis. Results The Delphi panel reached consensus on 53 potential items that were carried forward to the cohort phase. From the 2 time-points, 81 questionnaires were completed and analyzed; 38 potential items were eliminated on account of greater than 10% missing data, factor loadings, and uniqueness. The 15 unidimensional items retained in the scale demonstrated appropriate person and item reliability after (and before) removal of 1 item (anxious about footwear) that had a higher than ideal outfit statistic (1.75). The anxious about footwear item was retained in the instrument but only the 14 items with acceptable infit and outfit statistics (0.5-1.5 range) contribute to the summary score. Conclusions This investigation developed and refined the A-FORM (Version 1.0). The A-FORM items demonstrated favorable psychometric properties and are suitable for conversion to a single summary score. Further studies utilizing the A-FORM instrument are warranted. J Orthop Sports Phys Ther, Epub 22 May 2014. doi:10.2519/jospt.2014.4980.