# Record a Visit

Record a visit in Veterian — checking the patient in, the SOAP note sections, treatments and prescriptions, follow-ups, the four visit statuses, and checkout.

The visit holds the medical record. Everything the clinic did for a patient on one day is recorded here: examination notes, treatments, prescriptions and follow-ups. The invoice for the visit is produced at the end of it.

A visit does not start from an empty form. You check the patient in first, and Veterian creates the visit record from that.

## Where to Find This Section

- **Visits** in the left menu lists every visit.
- **Flowboard** shows today's visits as a board, so the whole team can see which stage each patient has reached.

## Checking the Patient In

**Patient Check-in** requires two fields: **Customer** and **Pet**.

Once you select the client, Veterian lists the records it already has for them:

- **Recent Appointments**: the client's appointments around today. Selecting one checks the patient in against that appointment.
- **Recent Vaccinations**: the same for vaccinations that are already scheduled.

If the patient has neither an appointment nor a scheduled vaccination, use **Continue Without Selection** to start the visit anyway.

> **Note**
> Checking a patient in from here marks the linked appointment as arrived on its own. You do not also need to mark it on the calendar. See [Appointment statuses](/appointments/appointment-statuses).

> **Caution**
> A patient can only have one visit open at a time. If one is already open, Veterian tells you so (*"You must complete the existing visit before starting a new one"*) and offers to take you to it. Complete that visit first.

## What a Visit Holds

The visit opens on its own navigation, in this order:

- **Visit Details**
- **SOAP Notes**
- **Administered Treatments**
- **Prescription**
- **Follow-ups**
- **Patient Checkout & Invoice**

You do not have to work through them in order, and a visit is valid with most of them empty. A vaccination-only visit may never go beyond the first two.

## SOAP Notes

**SOAP Notes** is the examination record, and it runs in a fixed order:

| Section | What goes in it |
|---|---|
| **Chief Complaint** (CC) | The main complaint, in the owner's terms |
| **History of Complaint** (HPI) | How the complaint developed |
| **Current Medications** | Medications and supplements the patient is already taking |
| **Clinical Findings** | What the examination found (see below) |
| **Clinical Assessment** | Your assessment of the patient's clinical condition, based on the findings |
| **Diagnoses** | The presumptive and definitive diagnoses. Picked from the clinic's list rather than typed. See [Diagnoses](/settings/diagnoses) |
| **Treatment Plan** | What you plan to do about it |

### Clinical Findings

**Clinical Findings** is not a single text box. It collects the objective record of the examination in four kinds of entry:

- **Vital Signs**: the measured values.
- **Physical Exam**: each system marked **Normal**, **Abnormal** or **Not Examined**.
- **File**: an uploaded document or image. A larger file is refused with *File size must be less than 10MB.*
- **Result Templates** and **Lab Results**: structured results. A template is a form your clinic defines once and fills in on each visit, so the same panel is recorded the same way every time.

Until anything is entered, the section reads *No SOAP notes have been added.*

## Treatments

**Administered Treatments** records what was given to the patient: *medications/treatments administered to the patient or to be administered by the pet owner*. Add the lines, then click **Save Treatments**.

Each line records how the treatment was given (**Oral Dose**, **Injection (Intramuscular or Subcutaneous)**, **Topical Dose (Applied on Skin)** and the rest) and whether the vet or the owner administers it.

> **Caution**
> Treatments are also the inventory and billing record. Once an invoice exists for the visit, changes to invoiced treatments are reflected on that invoice automatically. If an e-document has already been issued from that invoice, the quantity and invoice status of invoiced treatments can no longer be changed. See [Create an invoice](/billing/create-an-invoice).

## Prescription

**Prescription** is written on the visit and prints from it. Items are added one at a time.

## Follow-ups

**Add Follow-up Appointment** creates the post-treatment check-up appointment from inside the visit, so you can book it while the client is still at the clinic.

## Visit Status

A visit moves through four statuses, and you set them by hand from the visit itself:

| Status | What it means |
|---|---|
| **Checked-in** | The patient has arrived and the visit exists |
| **In Progress** | The examination is under way |
| **In Review** | Waiting on a result or a second opinion |
| **Completed** | The visit is finished |

**Flowboard** uses these statuses: each column corresponds to one stage, so changing the status here also moves the patient's card on the board.

## Checkout

**Patient Checkout & Invoice** is the last step of the visit: the treatments recorded above become invoice lines and the client pays. The invoicing screen is the same form documented in [Create an invoice](/billing/create-an-invoice). Treatments arrive already listed, and you add anything else the clinic sold.

Veterian asks you about two things at checkout:

- If an appointment is linked to the visit, Veterian asks whether to change that appointment's status too.
- If vaccinations were administered during the visit, it asks whether they should be marked as not administered. Use this if a dose was recorded but not actually given.

## Printing the Visit

**Print Visit Record** produces the visit record as a document. The fields and the fixed texts on that document are set once in the clinic admin panel, not per visit.

## Deleting a Visit

Deleting a visit deletes everything attached to it: medical notes, physical examinations, vital signs, results, files and prescriptions. The confirmation lists them before you commit.

> **Caution**
> A visit that has a treatment and an invoice on it cannot be deleted. Delete the treatment and the invoice first. Veterian does not do this for you, because both have already affected stock and payment records.