NYSCRI Contact Note (NYCN)

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Form Details

• Form Properties
  1. Form Title: NYSCRI Contact Note
  2. Start from an Existing Form - No
  3. Copyrighted Form - No
  4. Billable Progress Note - Yes
  5. Have multiple versions open at same time - No
  6. Open Blank on new version - Yes
• Required Fields - Yes
• Lookup Tables - Yes
  1. Code will pull from Facilities.
  2. Service Code will pull from Visit Types.
• Pre-Fill Logic - Yes
  1. Organization Name will prefill from Setup > Program/Billing Defaults > Company Info Tab.
  2. Program Name will prefill from the Program the patient enrolled in.
  3. Goals/Objectives will prefill from the most recent completed Treatment Plan.
• Fill to Logic - None
• Signatures
  1. Individual Signature
     • Sig Type: Patient (Optional)
  2. Staff Signature
     • Sig Type: Any
     • Route-To is available.
     • Signature locks the form.
  3. Supervisor Signature
     • Sig Type: Supervisor
     • N/A box defaults to checked.
     • Route-To is available.
     • Signature locks the form.

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Session Info Tab

1. Indicate Date of Service & Start/End time.
2. Indicate Contact Type.
3. Note all Individuals Present.
4. Describe New Issues/Stressors/etc.

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Goals/Objectives Tab

1. Document Goals & Objectives as directed.
   • Goals/Objectives will pre-fill from the saved Individualized Action Plan.
   • Grey out - Selecting NA will grey out Goals/Objectives section.

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Interventions Tab

1. Document Interventions as directed.

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Signatures Tab

Signature Credentials (see Credentials)

1. Individual Signature
   • Sig Type: Patient (Optional)
2. Staff Signature
   • Sig Type: Any
   • Route-To is available.
   • Signature locks the form.
3. Supervisor Signature
   • Sig Type: Supervisor
   • N/A box defaults to checked.
   • Route-To is available.
   • Signature locks the form.

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History Tab

1. No input. Individual’s recorded contact history is displayed.

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