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Signing and Cosigning Session Notes

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Signing a session note locks it as a permanent, read-only clinical record. Some practices also need a second team member, like a supervisor, to add their own signature to an already-signed note. This article covers both: how to sign your own notes, and how to cosign a note that someone else on your team has signed.

In this article:

Signing Notes

Signing a session note locks it as a permanent, read-only clinical record. On a Team plan, a second team member, like a supervisor, can also add their own signature to an already-signed note, as long as they're part of the same team as the note's owner. This article covers both: how to sign your own notes, and how to cosign a note that a teammate has signed.

Learn more about Creating and Managing Client Session Notes →

What Happens When You Sign

Signing a note automatically:

  • Makes the note read-only (permanently locked from editing).
  • Marks it as completed.
  • Locks client-sharing settings (you can't change what's shared after signing).

How to Sign a Note

  1. Create or edit a note.
     
  2. Click the Save button in the top-right corner.
     
  3. Select Sign and save from the dropdown menu.

     
  4. In the Sign & Save pop-up, confirm the Signing date. If you're signing a note that another team member created, you'll see a Sign notes as... dropdown to select yourself or your team member.
     
  5. Optionally, check the box to create a cosign task if the note needs a teammate's cosignature; see Creating a Cosign Task below for more details.
     
  6. If you haven't already added a signature to your account, you'll be prompted to create one.

Once saved, you'll notice a signature icon and "Signed (read-only)" label on the note in your client's Notes History page.

⚠️ Important: Signing a note is permanent; review your note carefully before signing. Once a note is signed, it can't be unsigned or edited.

Signing a Note on Behalf of a Teammate

On a Team plan, if you have access to another team member's client resources, you can sign one of their notes yourself rather than the note's owner signing it. If you're signing a note that another team member created, you'll see a Sign notes as... dropdown to select yourself or your team member.

  1. Open the note and click Save > Sign and save.
     
  2. In the Sign notes as... dropdown, select the note owner's name instead of your own.

     
  3. Complete the rest of the Sign & Save pop-up as usual, and click Continue.

The note is signed under the selected team member's name and signature, exactly as if they had signed it themselves.

Creating a Cosign Task

If a note needs a teammate's cosignature, the fastest way to route it to them is to create a cosign task right when you sign the note.

  1. When signing a note, check the box to create a cosign task.

     
  2. In the Select team member for cosign task pop-up, click the name of the team member who should cosign the note. Only team members with cosign permission appear in this list.
     
  3. In the Create Cosign Task pop-up, review the pre-filled task name and notes, and set a priority, duration, due date, and reminder if needed.

     
  4. Click Save.

The task appears in the note's Tasks tab, and in the assigned team member's task list.

Cosigning Notes

Some practices, particularly those with a supervision structure, need a second practitioner to formally sign off on a note after it's already been signed. Cosigning lets a team owner or a team member with the right permission add their own signature to a note that another team member has already signed, without reopening or altering the note's content.

📍 Note: Cosigning is entirely optional. A note is already complete and legally locked once it's signed. Cosigning adds a second, supervisory signature on top, it doesn't change the note's completed status, and Practice Better doesn't require or enforce a cosignature before a note counts as finished.

Before You Begin

Cosigning has two requirements:

  • The note must already be signed. There's no cosign action on a note that's still in progress; see How to Sign a Note above.
     
  • The cosigning team member needs the Clients: Notes: Cosign permission. Team owners have this permission automatically. For anyone else on your team, a team owner needs to grant it under that team member's permissions. Learn more about Managing Roles & Permissions for Team Members →  

📍 Note: A practitioner can't cosign their own note. The cosign action is only available to a different team member with the cosign permission.

What Happens When You Cosign

Cosigning a note:

  • Adds your signature and timestamp to the note, alongside the original signer's.
     
  • Regenerates the signed PDF to include both signatures.
     
  • Replaces the note's signed icon with a cosigned icon on the Notes History page, so it's clear at a glance that the note carries two signatures.

     
  • Does not reopen the note for editing. The original content stays exactly as the first signer left it.

How to Cosign a Note

The most common way to reach a note that needs your cosignature is through a cosign task. If the original signer assigned one to you when they signed the note, here's how to complete it.

  1. Go to My Schedule > My Tasks or locate your Tasks widget on your home dashboard.

     
  2. Click to open the cosign task assigned to you to view its details.
     
  3. Click the link to View session note to open it directly.

     
  4. In the top-right corner of the note, click Cosign. If you haven't already added a signature to your account, you'll be prompted to create one.

     
  5. Select a date preference from the dropdown:
    • Date prepared: the date the note was originally prepared.
    • Today's date: the current date.
    • Current date and time: the current date, with a timestamp.
    • Custom date: a date you choose.
    • Custom date and time: a date and time you choose.
       
  6. Click Continue to apply your signature.

💡 You don't need a cosign task to cosign a note. If you already know a note needs your cosignature, you can also open it directly and click Cosign in the top-right corner.

Reassigning a Cosign Task

If a cosign task was assigned to the wrong teammate, you don't need to create a new one. Open the task, go to its More Options menu (3 dots), and reassign it to the correct team member.

Tracking Cosigned Notes in the Unsigned Notes Report

The Incomplete & Unsigned Notes report includes a cosigned column, both in-portal and in the CSV export, so you can see at a glance which signed notes still need a team member’s cosignature and which are fully cosigned.

Downloading Signed and Cosigned Notes as PDFs

Both practitioners and clients (with whom the Note is shared) can download PDF copies of notes:

  • Practitioners: Go to your client record's Notes & Recordings section, click the More Options menu (3 dots) next to any note on the client's Notes History page, and select View as PDF. This opens the note as a PDF in a new browser tab, where you can download it. If the note has been cosigned, the PDF includes both signatures.
     
  • Clients: Go to your Session Notes section, click View on a note, and then click the Download button near the top-right.

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