ArkCloud Rehab
Review, signing and amendments
Every note type is signed the same way. Signing is the medico-legal act: it freezes the text under your name and credentials. After that a note changes only by amendment, and it can be locked for good.
Written for: Rehabilitation clinicians · Clinical supervisors · Rehab administrators · Compliance reviewers
From draft to locked
1ArkCloud Rehab
Draft
Saves as you type. Visible only to you and supervising roles.
2ArkCloud Rehab
Sign
Author only. Text, credentials and safety line freeze.
3ArkCloud Rehab
Co-sign (if needed)
A second clinician; the recorded supervisor where there is one.
4ArkCloud Rehab
Amend (if needed)
With a reason. The old wording is kept.
5ArkCloud Rehab
Lock (optional)
Permanent. Only addenda after this.
| Capability | Status | What that means here |
|---|---|---|
| Sign, amend, lock and addenda | Available | The author signs and the text freezes. A signed note changes only by amendment (with a reason, keeping the old wording), can be locked permanently, and can take signed addenda. |
| Signing requirements for each clinician | Available with configuration | A clinician can sign only once they have a discipline grant, an active staff record and a current professional licence, with no expired credential.Requires: An administrator sets this up under Outpatient, Clinician billing. |
| Co-signature | Available | A second clinician with signing authority can co-sign a signed note. Where the author has a supervisor recorded, only that supervisor can co-sign, and billing waits for it. |
| AI review attestation at signing | Available | A note that contains AI-drafted text, or for which an AI draft was shown, cannot be signed until the signer ticks a statement that they reviewed every AI-drafted section. |
Statuses you may see: Draft, Edited, Accepted, Completed (all unsigned), then Signed, Co-signed, Amended and Locked. An unsigned note is visible to its author and to Supervisor and Admin users only; a signed note is visible to everyone who can view the patient.
Review before you sign
Read the whole note as it will be signed. Check any text you inserted from a draft, a recording or the episode's records against what happened at the visit. Leave a section blank rather than writing a normal finding you did not assess.
When you press Sign, ArkCloud first checks the note and the visit against the same rules billing uses and lists anything that would hold the visit: a blank required section, a missing diagnosis or procedure code, minutes that do not support the units. It also lists what will need attention after signing. Fix what you can and sign, or press Sign anyway. A note signed with a required section blank is held from billing as "note incomplete".
A note with nothing in any section cannot be signed.
Signing
The note → Sign
- Press Sign.
- If the note contains AI-drafted text, or an AI draft was shown for it, the AI review statement appears. Read it, tick it, and press Sign again. Sign stays disabled until it is ticked.
- Review the sign check, then sign or press Sign anyway.
- Confirm it is you: your password, or the code from your authenticator app if you use two-factor authentication. One check covers further signatures for 10 minutes.
Only the note's author can sign it. Anyone else co-signs after the author has signed. Your credentials are copied onto the note at that moment, together with the allergies and precautions shown at the top of the note.
The AI review statement
The statement you tick reads, in full:
This note contains text drafted by AI. I reviewed every AI-drafted section against the patient and this visit, corrected what was wrong, and the signed note is my own clinical documentation.
It is required whenever AI-drafted text was inserted into the note, and also whenever ArkCloud delivered a draft for the note even if you inserted nothing. The words are recorded with your signature decision. Text built from your selections with no AI does not require it. The statement is not printed under the signature.
Signing requirements and billable signing
Billing checks the signature again: a visit is held if the note was signed, amended or co-signed by someone who did not meet these requirements at the time. Signing refreshes a visit's billing readiness (ready to bill, or held with a reason) instead of leaving it waiting on documentation; it does not create a charge. See charge capture.
Co-signature
- Only the note's author can sign it; anyone else co-signs.
- Only a signed or amended note can be co-signed, by a clinician who meets the signing requirements.
- The signer and the person who last amended the note cannot co-sign it.
- If the author has a supervisor recorded in Workforce, only that supervisor can co-sign, the visit is held from billing until they do, and the note cannot be locked before it.
- Your practice can also set documentation rules that require a co-signature for certain care.
- There is no separate student or assistant (PTA, COTA) workflow beyond the supervisor rule.
Amendments and addenda
| Field or control | What it means |
|---|---|
| Amend | Changes a signed note. The author, a supervisor or an administrator can amend. The reason comes first and is required. The signed wording is kept as a frozen version; the original signer stays the note's signer; the person amending is recorded on the note and on the archived version, with the reason (the note shows an "Amended by" line); any co-signature is cleared because it applied to the old wording. |
| Add addendum | Adds to a signed note without changing it: a later observation, a clarification, or a correction to a locked note. Any clinician who meets the signing requirements can add one. It is signed by its writer, shown beneath the note with their name, credentials and time, and cannot be edited or deleted. |
| Lock | Ends amendment permanently - there is no unlock. Only the clinician who signed it, its co-signer, the author's supervisor (as recorded in Workforce), or someone with the Supervisor or Admin role can lock it, and only once it is signed. |
What a signed note can no longer change
- Its text, except through an amendment that keeps the previous wording.
- Who signed it, their credentials at the time, and the allergies and precautions shown at signing.
- Its existence: a signed, co-signed, amended or locked note cannot be deleted, including by deleting the patient or the episode, and its archived versions cannot be altered. The database enforces this.
- Later corrections elsewhere (an outcome score marked entered in error, a corrected outside record) never rewrite a note.
Sending a signed note to a physician
| Capability | Status | What that means here |
|---|---|---|
| Sending signed notes to a referring provider | Needs an external connection | A signed evaluation, plan of care, progress report, re-evaluation, discharge summary or daily note is listed on the episode's Notes view under Share with an outside provider, but no Direct secure messaging or fax service is connected, so ArkCloud does not send a signed note anywhere today. The panel says that sending is not available.Requires: A Direct messaging or fax service connected to ArkCloud, and each recipient verified in the outside-provider directory. |
Troubleshooting
| Field or control | What it means |
|---|---|
| "Only the clinician who wrote this note can sign it" | You are not the author. Wait for them to sign, then co-sign. |
| Signature refused for credentials | Your discipline grant, staff record or licence is missing or expired. Ask an administrator to check Clinician billing. |
| Sign is greyed out | The AI review statement is showing and not ticked. |
| "This note has no content in any section" | Write at least one section before signing. |
| Co-sign refused | You signed or last amended the note, or a recorded supervisor must co-sign instead. |