The objective of this study was to develop a psychometrically valid, multidimensional, self-administered, general questionnaire measuring patient satisfaction with pharmacy performance for outpatients. A multiphase development process was employed to attain this goal. In Phase I, questionnaire's content was generated using interviews with pharmacy users regarding their experiences and expectations relating to pharmacies. In Phase II, the content and format of the questionnaire was defined in a two-round modified Delphi study, where an expert panel estimated importance of generated items for patient satisfaction. In Phase III, the initial validation of the questionnaire, which included a random sample of 5,400 patients coming out of the selected pharmacies, took place. The outcome of the development process is a questionnaire that focuses on issues expressed as important by patients, takes into account services as well as the supporting structure, and includes items relevant to an individual pharmacy and demonstrates satisfactory psychometric properties.