Phase 2 Contact Note (NYP2CN)

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Form Details

• Form Properties
  1. Form Title: Phase 2 Contact Note
  2. Start from an Existing Form – Yes, if there is a previous version signed and locked.
  3. Copyrighted Form – No
  4. Billable Progress Note – Yes
  5. Have multiple versions open at same time – Yes
  6. Open Blank on new version – No
• Required Fields – Yes
• Lookup Tables – Yes
  1. Code drop-down will pull from Facility Table.
  2. Service Code drop-down will pull from Visit Type table.
  3. Goal(s)/Objectives will pull from the most recently completed Individualized Action Plan.
• 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 is enrolled in.
• Fill to Logic – None
• Signatures
  1. Individual Signature
     • Sig type: Patient
  2. Completed By signature
     • Sig type: Any
     • Signature locks the form
     • Route-To is available
  3. Supervisor Signature
     • Credential required to sign: Supervisor.
     • Title will fill from title entered in user setup (see eCR University – Users).
     • Defaults to N/A checked.
     • Route To functionality is available.

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Session Info Tab

• The Organization Name will prefill from the Program/Billing Defaults/Company Info.
• The Program Name will prefill from the Program the patient is enrolled in.
• The Start Time and Stop Time will default to 12:00AM.
• The Loc. Code drop-down menu pulls from the Facility table.
• The Service Code drop-down menu pulls from the Visit Type table.

See Billing/Program Defaults - Glossary, Add or Edit Programs, Create or Modify a Facility/Location for more information. 

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Goals/Objectives Tab

• The Goal/Objective drop-down menus will reflect active/continued goals from the most recent IRP/IRPR.

Continued/Active Goals/Objectives from the most recent IRP/IRPR prefill to the Goal/objective drop-down.

Selecting “Based on Initial Plan for Services” indicates goals/objectives are from the initial time frame before formal goals/objectives are developed in a IRP. Checking “Based on Initial Plan for Services” will grey out the goals/objective drop-downs.

Interventions Tab

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Signatures Tab

1. Signature Type Credentials
   • Individual Signature
     • Sig type: Patient
   • Completed By signature
     • Sig type: Any
     • Signature locks the form.
     • Route-To is available.
   • Supervisor Signature
     • Credential required to sign: Supervisor
     • Title will fill from title entered in user setup (see eCR University Users).
     • Defaults to N/A checked.
     • Route To functionality is available.

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History Tab

Shows the history of all completed and open version of the particular progress note for the patient.

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