📝 Overview
The Patient Chart SOAP Notes screen is where providers document every visit. It brings together clinical charting, patient history, x-ray viewing, AI assistance, and note management in one workspace. This is the preferred SOAP Note method going forward and is being actively developed with new capabilities.
🔍 How to Get There
From the SOAP tab, select SOAP > Patient Chart.
Patients who have been arrived will appear in the adjustment queue on the left side of the screen, organized by provider.
Click a patient's name in the queue to open their SOAP Notes screen.
👤 Provider access required
Users must be set up as a Provider to access the SOAP Note tab. Administrator-only users will not see this option.
🧭 Top Navigation Bar
When a patient's SOAP Notes screen is open, the top bar shows:
Patient Info: Name, Date of Birth, Age, and Profile Picture (if uploaded)
Snapshot: Quick access to the full Patient Snapshot
Call Patient: Signals the patient is ready to return to the adjusting area
Treatment Date: Defaults to today's date
Pregnancy Tracker: Displays pregnancy info from the patient's profile (pink for girl, blue for boy)
👥 Adjustment Queue
Each provider has their own queue on the left side of the screen.
Queues can be expanded or collapsed.
Draft notes and incomplete notes are accessible here for easy management.
📁 Case Information
Displays current visits and total visits across all case types.
Toggle between active cases if the patient has more than one.
💰 Charges
Displays default charges for the patient.
If no default charges are set, a red warning appears. Click the area to set defaults quickly.
Edit charges directly: add or adjust services, modify units, DX mapping, modifiers, or financial responsibility, and apply copay, deductible, or co-insurance.
📋 Chief Complaints and Care Notes
Pulled directly from the patient's case settings.
Auto-sync between the SOAP screen and the patient profile — updates in either location reflect instantly.
These notes are case-specific. They are not visible across cases.
📋 Listings
The Listings panel gives providers quick access to spinal listings for the current visit. Click into the Listings area to assign listings.
You can choose to pin either Listings or the Extra Patient Notes box as your default view — see the Pinning Your Default View section below.
🩻 Imaging and Documents
X-rays and other documents uploaded to the patient's profile are viewable on the SOAP Notes screen.
Drawing tools are available for patient discussions. These do not annotate the actual file.
Side-by-side X-ray comparison is supported by clicking directly on an image to open the inline view.
🖼️ X-Ray Pop-Out Window
X-ray images can be opened in a separate, movable browser window — allowing providers to view imaging and document a SOAP note at the same time.
How to pop out an x-ray:
On the SOAP Notes screen, hover over an x-ray image.
A pop-out icon appears in the top corner of the image.
Click the icon. The image opens in a separate, movable browser window.
Drag the pop-out window to a second monitor or reposition as needed.
Continue working in the main ChiroHD window — the pop-out stays open independently.
Additional details:
File type required: The pop-out icon only appears on image files (JPEG, PNG). PDF documents do not show the pop-out option.
Multiple x-rays can be popped out into separate windows simultaneously.
Each pop-out window shows the patient's first name and last initial for HIPAA-safe identification when multiple windows are open.
Clicking an image directly (without the pop-out icon) still opens the standard inline view with annotation and side-by-side comparison tools. That workflow is unchanged.
📌 Extra Patient Notes Box
The Extra Patient Notes box is for information that needs to stay visible regardless of which case is open — billing flags, medication sensitivities, communication preferences, or any note that should follow a patient long-term.
How it works:
Patient-wide persistence: Notes entered here stay visible across all cases. They do not reset between visits and do not disappear when a case closes.
Font styling: Text can be formatted (bold, italic, larger font) to make important notes easier to scan.
Distinct from other note boxes: The standard blue Patient Notes box (visible in the snapshot and front desk view) and Chief Complaint and Care Notes are all case-specific. The Extra Patient Notes box is the only notes field that actively follows the patient across all cases on the SOAP Notes screen.
💬 Common question: Do extra patient notes reset each visit?
No — they persist indefinitely across all visits and all cases until manually edited or cleared.
📍 Pinning Your Default View
On the SOAP Notes screen, you can choose which panel loads as your default view when you open a patient: Listings or Extra Patient Notes.
To pin Extra Patient Notes as your default:
Open any patient's SOAP Notes screen.
Locate the Extra Patient Notes box.
Click the pin icon to set it as your default view.
To switch back to Listings as your default:
Locate the Listings panel.
Click the pin icon on the Listings panel.
🔁 Re-Using a Previous Note
To save time on repeat visits, ChiroHD offers options for pulling in a prior note:
Re-Use Last Note: Copies the most recent note in the same case, regardless of which provider wrote it.
Re-Use Last Note — Same Provider: Copies the most recent note in the same case written by the same treating provider. Use this when multiple provider types share a case but document differently.
Reuse a specific past note: From the Patient Info tab > Recent Visits, select and reuse any past note — not just the most recent one. Helpful for re-exams or service-specific templates.
ℹ️ Case boundaries are always respected
Re-use only looks within the current case. If a patient has multiple cases, the re-use function will not pull a note from a different case.
👤 Patient Info Tab
The Patient Info tab gives providers reference information without leaving the SOAP Notes screen.
Patient Notes Box: The standard blue notes box, synced with front desk and provider views.
Diagnosis Codes: View and edit.
Upcoming Alerts: For example, upcoming re-exam or x-ray schedules.
Tags: View and edit patient tags.
Recent Visits: View recent SOAP notes, identify missing notes, and reuse any specific past note.
🤖 AI Features
Two AI features are available on or alongside the SOAP Notes screen.
Intake AI — Subjective Auto-Population
When a patient completes their digital intake paperwork (ChiroHD paperwork only), the AI reads their responses and generates a summary. The provider can review and import that summary directly into the Subjective section of the SOAP note.
A toggle is available for practices that do not want to use this feature. Offices using SKED forms instead of ChiroHD digital paperwork cannot use this feature.
AI Care Summary
Accessible from the Documents tab on the patient's profile. Generates a condensed summary of the patient's full care history across all SOAP notes and all cases.
The first time you click it, it populates automatically.
To refresh it with new visits, click Refresh — it does not update automatically.
💬 Troubleshooting tip: There are two AI summaries that look similar. The Intake AI summary appears as a prompt on the SOAP note screen before you start documenting. The AI Care Summary lives under the Documents tab and covers the patient's full history. When troubleshooting an AI question, ask for a screenshot or confirm which screen they're on before responding.
💾 Saving and Submitting Notes
At the bottom of the screen, the following options are available:
Button | Action |
Close | Exit the SOAP screen without saving |
Save as Draft | Save the note into the Draft Queue to finish later |
Submit and Assign | Submit the current note and assign the patient to another provider or room |
Submit | Submit the SOAP note and automatically post charges to the Ledger |
✅ Key Takeaways
The Patient Chart SOAP Notes screen is the preferred documentation method in ChiroHD.
Extra Patient Notes are patient-wide and persist across all cases. They do not reset between visits.
X-rays can be popped out into a separate, movable browser window for dual-monitor use. The pop-out icon only appears on image files (JPEG, PNG), not PDFs.
Both the Listings panel and the Extra Patient Notes box can be pinned as the default view. If your Listings disappeared, pin it back using the pin icon on the Listings panel.
Re-use options always respect case boundaries — they will not pull notes from a different case.
Two AI features are available: Intake AI auto-fills the Subjective from digital paperwork (toggle available), and AI Care Summary summarizes full care history under the Documents tab (requires manual refresh after first load).
📌 Conclusion
Use Extra Patient Notes for anything that needs to survive a case closing. Use Chief Complaint and Care Notes for information specific to the current case only.
Pin whichever panel matches how you start your documentation process. If spinal listings are the first thing you need at every visit, keep Listings pinned. If patient-level flags are more critical to see first, pin Extra Patient Notes.
Pop out x-rays when your technique or patient conversation requires viewing imaging while you chart. Use the inline view when you need annotation or side-by-side comparison tools.
If Intake AI is active for your network, review the pre-filled Subjective before proceeding — it is AI-generated from the patient's intake form and should be confirmed, not treated as final.