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Signing Clinical Notes

Clinical notes must be signed to be considered complete. Signing makes the note immutable and audit-ready.

Signing Deadline​

Signing Deadline

Clinical notes should be signed promptly after the session. The deadline enforced at signing defaults to 24 hours and can be configured by your practice administrator in the practice settings. If you exceed the deadline, the late signing is flagged in compliance reports, and practitioners who are flagged as requiring supervision have their supervisor notified. :::

Why Sign Promptly?​

  • Ensures timely documentation while memory is fresh
  • Supports Medicare compliance
  • Professional standards (AHPRA guidelines)
  • Protects you in case of complaints or audits

Late Signing​

Notes signed after your organisation's signing deadline:

  • Are flagged in compliance reports
  • Trigger an overdue notification to you and your supervisor (if applicable)
  • An audit trail entry is automatically created recording the overdue status
  • The time past deadline is recorded for compliance reporting

Note Status Before Signing​

Notes follow the status workflow: Draft -> Final -> Signed (locked) -> Amended (if addendum added).

  • A note must be marked as Final before it can be signed
  • While in Draft status, the note is still a work in progress
  • Moving to Final indicates the note is complete and ready for review/signing
  • Once signed, the note is permanently locked and immutable
  • Adding an addendum to a signed note transitions it to Amended status

How to Sign​

From the Note Editor​

  1. Complete your note and mark it as Final
  2. Review all sections
  3. Click Sign Note or press Cmd+Shift+S
  4. Confirm the signature

From the Notes List​

  1. Go to Notes
  2. Filter to show unsigned notes
  3. Click the sign icon on each note
  4. Confirm

Batch Signing​

For multiple unsigned notes:

  1. Select notes using checkboxes (up to 20 at a time)
  2. Click Sign Selected
  3. Review the summary showing client names, dates, and note count
  4. Confirm the batch signature with the confirmation checkbox
  5. Praxi signs each note individually and shows progress, including any notes that failed (e.g., unresolved verification flags)

Requirements Before Signing​

Before Praxi allows you to sign a note, the following conditions must be met:

  1. Note must be in Final status -- mark the note as Final first
  2. AI attestation (if applicable) -- if the note was generated by AI, you must attest to its accuracy by confirming you have reviewed the content
  3. Verification flags resolved (if applicable) -- if the note was generated from a voice transcription, any sections flagged with [VERIFY] must be reviewed and resolved
  4. Supervisor approval (if applicable) -- provisionally registered practitioners must have their supervisor approve the note before signing

Review Checklist​

Review your note for:

  • Accurate client information
  • Correct session date
  • Complete content
  • Risk assessment included
  • Spelling and grammar
  • Professional language
  • No placeholder text remaining
Review Before Signing

Once signed, notes cannot be edited. They are permanently locked and immutable. Take a moment to review before signing. :::

What Signing Does​

When you sign a note:

  1. Locks the content - No further edits possible
  2. Records signature - Your name and credentials
  3. Timestamps - Exact date and time recorded
  4. Audit trail - Added to compliance records
  5. Billing - Note becomes claimable (if applicable)

Making Corrections​

Before Signing​

Edit freely -- changes are tracked in version history with change reasons.

After Signing​

You cannot edit a signed note. Instead, add an addendum:

  1. Open the signed note
  2. Click Add Addendum
  3. Select the addendum type:
    • Supplementary -- additional information not in the original note
    • Correction -- correcting an error in the original note (you can specify the corrected section, original text, and reason for the correction)
  4. Write the addendum content
  5. The addendum is automatically signed and timestamped
  6. The parent note's status changes to Amended
Who Can Add Addendums?

Addendums can be added by the original note author, the note's supervisor, or a practice owner. :::

Unsigned Notes Dashboard​

Your dashboard shows:

  • Number of unsigned notes
  • Time since session
  • Colour-coded urgency based on your organisation's signing deadline

Reminders​

Praxi sends automated reminders for unsigned notes based on a signing window tiered by your profession (72 hours for AHPRA-regulated professions such as psychologists and physiotherapists; longer for self-regulated professions):

  1. At ~50% of the window -- Standard reminder notification
  2. At ~75% of the window -- Urgent reminder notification
  3. At 100% of the window -- Overdue notification sent to you (and your supervisor if you are flagged as requiring supervision), plus an audit trail entry

For example, an AHPRA-regulated practitioner receives reminders at approximately 36 hours (standard) and 54 hours (urgent). Reminders are checked hourly. Note that the reminder window is profession-based and separate from the practice-configured deadline enforced at signing.

Daily Pending Actions

In addition to signing reminders, Praxi sends a daily summary at 9am of any pending AI-extracted actions from your notes that need approval or dismissal. Actions older than 7 days are automatically expired. :::

Supervisor Review​

Provisionally registered practitioners and interns must have their notes reviewed by a supervisor before signing. This is an AHPRA requirement.

Review Workflow​

  1. Intern writes and completes the note
  2. Intern marks the note as Final
  3. Intern clicks Submit for Review and selects their supervisor
  4. Supervisor is notified that a note awaits review
  5. Supervisor reviews the note content
  6. Supervisor either approves the note or requests changes with feedback
  7. If changes are requested, the intern revises and resubmits
  8. Once approved, the intern can sign the note
  9. All review actions are recorded in the audit trail

Who Requires Supervisor Review?​

Supervisor review is required when:

  • The practitioner's registration status is provisional
  • The practitioner has requires supervision enabled on their profile
  • An active supervision relationship exists with approval required for reports enabled

Supervisors can view all pending reviews, review history, and approval statistics from the supervision dashboard.

Signature Details​

Each signature records the signing practitioner and a precise timestamp on the note itself, permanently locking it. The signing event -- including the device's IP address -- is also written to the immutable audit trail.

Compliance Reporting​

View signing compliance:

  1. Go to Reports > Compliance
  2. Select Note Signing
  3. See:
    • % signed within the organisation's signing deadline
    • Average time to signature
    • Overdue notes by practitioner

Tips​

  1. Sign same day - Don't wait until the deadline
  2. Set a routine - Sign notes at end of each day
  3. Use the dashboard - Check unsigned notes daily
  4. Enable reminders - Let Praxi prompt you
  5. Review before signing - Avoid addendum notes

Troubleshooting​

Can't sign?​

  • Check the note is marked as Final (not still in Draft)
  • If the note was AI-generated, ensure you have attested to its accuracy
  • If there are [VERIFY] flags from voice transcription, resolve all of them
  • If you require supervision, ensure your supervisor has approved the note
  • Verify you are the note author

Need to edit after signing?​

Add an addendum -- this is the audit-appropriate approach. Select either Supplementary (new information) or Correction (fixing an error).

Reminder not received?​

  • Check notification settings
  • Verify email address
  • Check spam folder

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