This article describes the procedures used to determine the conceptual adequacy and cultural appropriateness of a newly developed HIV Testing Enablers Assessment (H-TEA) instrument to be used with underserved Hispanic/Latino immigrant women. The aim was to create an appropriate format for women with similar language proficiencies and ethnic backgrounds. We discuss the feedback we received from the women in terms of cultural nuances we must pay attention to when creating items and organizing them into an assessment instrument. Women reported on the understandability, comfort level, likelihood of truthfulness, and cultural relevancy of questions and response options for the instrument. These are key factors in developing an instrument that is relevant, reliable, and culturally appropriate for our target population.