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Case Notes Overview

The Case Notes feature allows Team Members to create and store documentation related to a patient's care. 

 

✍️ Creating a New Case Note

To create a new Case Note:

  1. Go to the Patient Profile.

  2. Select the Case Notes tab.

  3. Click + Case Note.

You’ll be taken to the Case Note Entry screen.

Case Note Entry Fields

  • Patient Info: Auto-filled at the top with patient name, DOB, and Identifier.

  • Clinician / Discipline: Auto-filled based on the Team Member completing the note.

  • Linked Appointment: Use the dropdown to attach a specific appointment to this Case Note (optional).

  • Template: Click Select Template to choose a pre-defined structure (e.g. Psychology Note, Group Program Note).

    • Templates are created via the Administration -> Case Note Templates screen.

    • Selecting a template will overwrite any existing content in the editor. A warning is shown before proceeding.

  • Title: Enter a title for your note (e.g. “Case Note”, “Psych Note”).

  • Case Note: A rich text editor where you can write your clinical note. Includes:

    • Text formatting

    • Bullet/numbered lists

    • Checkbox lists

    • Table and quote insertion

    • Link/image support

    • Dynamic terms (e.g. patient name)

    • Markdown/code view

Actions

At the bottom of the screen, you can:

  • Cancel – exit without saving

  • Save & Exit – save the note as In Progress and return later to complete

  • Save & Finalise – lock the note as a final version

  • Delete – permanently delete the note (available before finalisation)

📚 Case Notes List View

The Case Notes tab within a patient's profile displays all notes in a sortable table.

Each row shows:

  • Created On – Date/time the note was first created

  • Title – Clickable to open the Case Note

  • Template – The template used (if any)

  • Created By – Name of the Team Member

  • Discipline – Profession of the Team Member

  • Note Status – Either In Progress or Finalised

  • Linked Appointment – Session name/date, if linked

  • Last Modified – Date/time of the most recent update

You can filter notes by:

  • Discipline

  • Author

  • Template

Use the pagination controls to navigate between pages.

🧠 Additional Tips

  • Where appropriate link a Case Note to an appointment to help track clinical services.

  • Use templates to standardise documentation across your team or service.

  • Finalise notes when they are complete.

  • A note author can click Lock under the ••• Action button to restrict the note's contents. Locked notes can be viewed by the author, and by Team Members whose Role includes the View Locked Case Notes permission.