PSYBooks has fields where you can add notes to almost any form in a client’s chart. For example the area on the Add Session form for adding notes looks like this:
This particular note area has optional formatting tools if you want to use them. There are radio buttons beneath the textarea that allow you to specify whether you want this note to be part of the medical record or a personal psychotherapy note, and a checkbox to the left of the words Electronic Signature which allows you to sign the note when you’re ready.
The checkbox that’s after the signature line and has an exclamation point beside it () is called the “Mark Important” tool. Checking this box will allow you to filter all notes that you have marked as important so you can view only those notes when you go to the Notes tab of the client’s chart. All notes in PSYBooks have both the signature line and the ability to mark a note as important.
The particular note above (i.e., the one on the Add Session form) also has an “Other Note Types” box in the upper right. This box has links to some structured notes you may want to use when you are adding a session: Intake Note, Treatment Plan and Progress Note. Structured notes have fields such as dropdown boxes and checkboxes which can allow you to fill out required data more quickly.