AI Clinical Documentation

PT SOAP note generator — 60 seconds

Input your clinical findings. Get a complete, payer-appropriate SOAP note. Every note is medically accurate, functionally framed, and ready to customize in your EMR.

Free account · No credit card

Example output

What a generated note looks like

Generated note · Post TKA · Outpatient 47 seconds

Subjective

Patient is a 67 y/o male referred for outpatient PT following right TKA (4 weeks post-op). Reports pain 4/10 at rest, 7/10 with stair negotiation. States stiffness is worst in the morning. Goals: return to golf by 3 months.

Objective

ROM: R knee flexion 95° (baseline 105°), extension -5° (baseline 0°). MMT: R quad 4-/5, hamstrings 4/5. Patellar mobility: reduced superior glide. Gait: antalgic pattern with shortened R stance phase, mild knee flexion during swing. TUG: 14.2 sec (>12s indicates fall risk).

Assessment

Patient demonstrates restricted knee ROM and quad weakness limiting functional mobility and gait efficiency at 4 weeks post TKA. Deficits are consistent with expected post-surgical course; however, limited extension is a concern requiring targeted intervention to prevent arthrofibrosis.

Plan

Skilled PT 3x/week x 6 weeks. Treatment: quad sets, SLR progression, patellar mobilizations (inferior/superior), stationary bike (10 min, low resistance), stair training eccentric focus. HEP updated and reviewed. STG: knee flexion 115°, extension 0° by 2 weeks. Patient verbalized understanding and agreement with plan.

Output is a starting point — always review, verify, and edit before use in a patient record.

Built for PT documentation

Payer-aware language

AI avoids passive language that triggers denials. 'Skilled PT required because…' is built into every note.

Functional goal framing

All goals are written in functional, measurable, time-bound format — consistent with Medicare and commercial payer requirements.

Setting-specific templates

SNF notes look like SNF notes. Outpatient notes look like outpatient notes. The AI adapts to your setting automatically.

Fully editable output

Every generated note is a starting point, not a final document. Edit directly in the platform before copying to your EMR.

ICD-10 code suggestions

The AI suggests relevant ICD-10 codes based on your clinical inputs. Verify and add to your note with one click.

Generates in under 60 seconds

Input key clinical findings — ROM, MMT, functional limitations — and get a complete SOAP note in under a minute.

Works for every PT setting

Outpatient ortho & sports
SNF / long-term care
Home health
Hospital / acute care
Inpatient rehab (IRF)
Pediatric outpatient
School-based PT
Telehealth visits

Free to start

Spend less time on notes. More time with patients.

Free account includes SOAP note generation, NPTE prep, and PT career tools. No credit card.

No credit card required · Free forever on core features