To facilitate surveys of psychoactive medication treatment, we developed the Psychoactive Medication Quality Assurance Rating Survey (PQRS), a chart review instrument for trained raters. It evaluates the clinical information, decision processes, and provisions for monitoring treatment outcome associated with the use of psychoactive medications. Two raters, a child and adolescent psychiatrist and a developmental pediatrician, independently completed the PQRS on a simple random sample of 78 individuals residing at a developmental center in upstate New York, and established preliminary evidence indicating good interrater reliability. Although further psychometric evaluation to establish test-retest reliability and validity on larger, varied populations is necessary, the PQRS is a valuable tool for surveys to evaluate the quality of treatment with psychoactive medications.