How do I write a SOAP note?

From TherapyCharts


The TherapyCharts system has a generalized Progress Note form (shown on the progress note tab) to allow one to write any kind of progress note. Since the SOAP note format is just a more structured and formalized progress note, there are two approaches to writing SOAP notes in TherapyCharts. (When we're talking about SOAP notes we're talking about these: http://www.coe.ufl.edu/Counselor/PracticumInternship/Files/SOAPNotes.pdf) First, simply write the text of your SOAP note as you usually would in the free text "Progress Note" field on the Progress Note form -- done. This approach requires little change in your current process but doesn't take full advantage of the features of TherapyCharts. Alternatively, TherapyCharts encapsulates parts of the SOAP note in other fields. Each Progress Note form (as shown on the progress note tab) contains fields that address those required in a SOAP note. We have a "Progress Note" free text field for subjective or objective data, we integrate the reported symptoms independently with an updateable field for objective data which allows for independent tracking, and we include the treatment plan objectives and medication management for treatment planning. Flexibility and choice are yours. Use all, some, or none of the available fields and approaches.