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How to Create a Clinical Note

Updated this week

Clinical Notes in PlaySpace help you document your sessions, track client progress, and maintain accurate and secure records. Notes can be written, uploaded, or voice-recorded, whichever best supports your workflow and clinical style.

Follow the steps below to create a new clinical note.

1. Log into your PlaySpace account and navigate to Clinical Notes

Once logged in, look to the left-hand menu under Your Practice and select Clinical Notes.

This will bring you to your full notes dashboard where you can view all past notes, search by client, and see any notes that need to be completed.

2. Click the “New note” button

In the top right corner, select New note.

You’ll see three options:

  • Record – record an audio note

  • Upload – upload a note file (e.g., PDF, DOCX)

  • Write – type your note directly in PlaySpace

Please see the chart below for step-by-step instructions for each note type:

Note Method

Steps

Record

  • Select 'Record' under the New Note dropdown menu. A new pop up menu will appear on your screen where you can assign the note to a client, test your microphone, and begin recording.

  • Assign the note to a client under the 'Assign Client' dropdown

  • Select 'Start Recording'

Upload

  • Select 'Upload' under the New Note dropdown menu. A new pop up menu will appear on your screen where you can upload your note file and assign it to your client.

Write

  • Select 'Write' under the New Note dropdown menu. A new pop up menu will appear on the right-hand side of your screen where you can begin writing your note and assign it to a client.

3. Sign and Lock the Note

When you’re finished creating any type of note:

  • Click Sign & Lock

This completes the documentation and prevents unintended edits. You can still edit notes later if more clarity or follow-up information is needed. To do so, simply click on 'Un-sign and edit' once a note has already been signed and locked.

Note Settings:

In your Clinical Notes Section, you will see a 'Settings' button on the right-hand side of the screen. In your Clinical Note Settings, you can:

  • Browse between AI-generated note templates and manual note templates to use

  • Create personalized note signatures (including your name, signature label image, credentials, license, and registration number).

That’s it!

Creating clinical notes in PlaySpace is designed to be simple, efficient, and aligned with your clinical workflows, whether you’re working with children, adolescents, adults, or neurodivergent individuals.

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