Entering Clinical Notes

After each appointment, the clinical providers in your office write detailed, accurate clinical notes, and are an essential part of the clinical record. You can easily document a patient’s visit by manually entering the note or by using a template, which is even more efficient and can lead consistency and accuracy.

Watch this video to learn how to enter a clinical note. (Duration: 1:18)

Additional Information

• Depending on the set up of a clinical note template, there may be multiple prompts to walk you through the creation of the clinical note.

• Saving a clinical note does not lock the note or prevent it from being edited. Clinical notes are only locked when it is signed. If you want to lock a clinical note and prevent it from being edited, you should sign the note.

• To learn how to modify the content of a clinical note template, read Customizing clinical note templates in the knowledge base.

• To learn how to promote selected clinical note templates so they’re right at hand, read Adding clinical note templates to the list of favorites in the knowledge base.