Configuring Note Signing Requirements

Last updated: December 30, 2025

Configuring note signing requirements gives you control over which note types need formal provider signatures. This helps you meet regulatory requirements while keeping workflows flexible for different types of documentation. We'll walk you through the setup process and help you make smart decisions about when to require signatures.

Before you begin

What you'll need:

  • Administrative access to Settings

  • Permission to modify note type configurations

  • A clear understanding of your practice's documentation and compliance requirements

Good to know upfront:

  • Configuration changes only affect future notes—existing notes stay as-is

  • Different note types can have different requirements

  • You can always adjust settings as your workflows evolve

How to configure a note type to require signatures

Here's the step-by-step:

  1. Go to Settings > Events and Note Types

  2. Find and select the note type you want to configure

  3. Look for the Is sig required checkbox

  4. Check the box to require signatures for this note type

  5. Click Save and you're done!

Once you enable this:

  • Notes of this type will show a Sign button instead of Lock

  • Users have to sign the note after locking it

  • PDFs are generated when signed (not when locked)

  • The PDF includes a SIGNATURES section instead of LOCK HISTORY

  • Each signed event gets a View PDF link for version tracking

How to configure who can sign notes

Your practice can control signing permissions at a system level:

To restrict signing to note creators only:

  1. Enable the RESTRICT_NOTE_SIGNING_TO_PROVIDER configuration setting

  2. When this is on:

    • Only the provider who created the note can sign or lock it

    • Only that provider can amend or unlock their own notes

    • Common for practices that need strict provider accountability

To allow multiple staff members to sign:

  1. Disable the RESTRICT_NOTE_SIGNING_TO_PROVIDER configuration setting

  2. When this is off:

    • Multiple staff members can sign the same note

    • Any authorized user can amend signed notes

    • Great for collaborative or teaching environments

Which note types should require signatures?

Here's our guidance based on what works well for most practices:

Consider requiring signatures for:

  • Billable encounter notes

  • Procedure notes

  • Consultation reports

  • Discharge summaries

  • Any notes with regulatory signing requirements

  • Documentation that goes in official medical records

Consider NOT requiring signatures for:

  • Internal messages between staff

  • Letters sent to patients

  • Administrative notes or internal communications

  • Phone encounter logs (unless they're billable)

  • Quick documentation that doesn't need formal signing

The best approach? Work with your compliance team to figure out what makes sense for your specific practice and regulatory environment.

How signing configuration affects your notes

Let's see what changes when you configure a note type:

For note types with signature required:

  • Sign button appears instead of Lock

  • One click both locks and signs the note

  • Amend button appears for making changes

  • PDF generated at signing includes SIGNATURES section

  • Note footer shows locked, signed, and amendment events

  • Each signed event includes a View PDF link

For note types without signature required:

  • Lock button appears

  • One click locks the note

  • Unlock button appears for making changes

  • PDF generated at locking includes LOCK HISTORY section

  • Note footer shows locked and unlocked events

  • Each locked event includes a View PDF link

Understanding signature vs. lock history in PDFs

Your PDF templates change based on whether signatures are required. Here's what you'll see:

Signed notes display:

  • SIGNATURES heading

  • "Electronically signed by [provider name] on [date] at [time]"

  • "Amendment initiated by [provider name] on [date] at [time]"

  • Events listed oldest to newest (ascending order)

  • Does NOT show locked events

Locked notes display:

  • LOCK HISTORY heading

  • "[Provider name] locked this note on [date] at [time]"

  • "[Provider name] unlocked this note on [date] at [time]"

  • Events listed oldest to newest (ascending order)

Testing your configuration

After you enable signature requirements, it's smart to run through a quick test:

  1. Create a new note of the configured type

  2. Check that the Sign button appears instead of Lock

  3. Complete and sign the note

  4. Look at the note footer to confirm you see both locked and signed timestamps

  5. Click the View PDF link to verify the SIGNATURES heading appears

  6. Test the Amend function to make sure it works as expected

For non-signature notes, do a similar check:

  1. Create a note of an unconfigured type

  2. Verify the Lock button appears

  3. Complete and lock the note

  4. Check that only the locked timestamp shows up

  5. Click View PDF to verify LOCK HISTORY heading appears

Taking a few minutes to test saves headaches later!

Common configuration scenarios

Let's look at some typical setups:

Scenario 1: All billable notes need signatures

  • Check Is sig required for all your billable note types

  • Consider enabling RESTRICT_NOTE_SIGNING_TO_PROVIDER if only rendering providers should sign

  • Run test encounters to verify the workflow makes sense

Scenario 2: Mixed workflow (some signed, some locked)

  • Require signatures only for provider encounters

  • Leave internal messages and administrative notes without signature requirements

  • Make sure your team knows which note types use which button

Scenario 3: Multi-provider practice with collaborative care

  • Disable RESTRICT_NOTE_SIGNING_TO_PROVIDER

  • Let multiple providers sign the same note as needed

  • Perfect for teaching environments or care teams where multiple providers contribute

Troubleshooting configuration issues

Running into snags? Here's how to sort them out:

Staff aren't seeing the Sign button

  • Double-check that Is sig required is enabled for that note type

  • Make sure they're creating a new note (existing notes keep their old configuration)

  • Verify the note type version has the correct setting

Wrong button is appearing (Sign when they expect Lock, or vice versa)

  • Review the note type configuration in Settings

  • Make sure Is sig required matches what you actually want

  • Remember: existing notes won't change—only newly created notes show the new configuration

Staff can't sign notes they should be able to

  • Check if RESTRICT_NOTE_SIGNING_TO_PROVIDER is enabled

  • Verify the user is the note creator (if restriction is on)

  • Confirm the user has appropriate signing permissions in general

PDF showing wrong template (SIGNATURES vs LOCK HISTORY)

  • This is actually expected for notes created before you changed the configuration

  • New notes will use the correct template

  • Historical notes keep their original template—this is good for compliance!

Best practices for configuration

We recommend:

  • Writing down which note types require signatures (documentation helps everyone!)

  • Training your team on the difference between Sign/Lock and Amend/Unlock

  • Testing configuration changes in a non-production environment if possible

  • Reviewing your configuration periodically as workflows change

Try to avoid:

  • Changing signature requirements on active note types without giving people a heads-up

  • Requiring signatures for note types that really don't need formal signing

  • Assuming everyone understands what the configuration means (communicate clearly!)

  • Forgetting to update your training materials when you change things

Frequently Asked Questions

Can I require signatures for some locations but not others?

Unfortunately no—the signature requirement is set at the note type level and applies across your whole practice. If you need different requirements for different locations, you'd need to create separate note types for different workflows. Chat with your Canvas implementation team if you're trying to solve this!

What happens to my existing notes when I turn on signature requirements?

Great question! Existing notes don't change at all. They keep their original locked state and PDF template exactly as-is. Only newly created notes of that type will require signatures. This protects your historical documentation from any weird retroactive changes.

Can I change the requirement after notes are already created?

Yep, you can change the configuration whenever you need to. Just keep in mind that notes already in the system will stick with whatever configuration existed when they were created. Only brand-new notes will reflect your updated setting. This prevents confusion with documentation that's already in progress.

How do I find out which restriction setting is enabled?

Your Canvas Medical support team or implementation specialist can tell you. The RESTRICT_NOTE_SIGNING_TO_PROVIDER setting is a system-level configuration that isn't visible in the regular admin interface. Just reach out and they'll let you know what you've got!

Can I customize what shows up in the signature section of my PDFs?

The signature section format is standardized to ensure regulatory compliance and keep documentation consistent. You can't customize the signature block content itself, but the information displayed is comprehensive for audit purposes. The standardization is actually helpful—everyone's PDFs look the same, which makes reviews easier!

Do message and letter note types need signatures?

Generally, message and letter categories don't require signatures, even in environments where RESTRICT_NOTE_SIGNING_TO_PROVIDER is turned on. These are typically administrative communications rather than clinical documentation. But you can always configure them to require signatures if your specific workflow needs that!

How does this help with compliance and regulatory requirements?

The signature feature creates a much stronger audit trail by separating the signature event from the locking action. You get explicit documentation of who reviewed and approved each note, along with a complete amendment history. This alignment with regulatory expectations makes audits smoother and gives you better accountability. Work with your compliance team to figure out which specific note types need signatures based on your regulatory requirements!