TheraNest allows for you and your client to sign the following documents:

  • Contact Log 
  • Initial Assessment
  • Addendums
  • Progress Notes
  • Treatment Plans
  • Custom Forms

It is up to you which documents require you and/or your client's signature. To sign any of the documentation above click on the down carrot arrow next to the save button. Choose to Save & Esign.

You will be presented with the option for both you and your client to sign the document.

Click here to learn how to Create/Manage your Electronic Signature

Only users with Admin permissions can remove signatures. Signatures must be removed in order to edit or delete a document. See article here:

Removing Electronic Signatures from Progress Notes and Initial Assessment Forms

Some documents cannot have the signature removed, no matter what permission level you have, including Admins. Those documents are: Contact Log Notes, Addendums, Treatment Plans, and Custom forms. You'll be presented with the following message when you sign a document that cannot be unsigned:

Notes requiring supervisory review may also have signature removal restrictions. Below is an image of the Therapist staff permission requiring supervisory review:


  • Can Access Patient Notes:

This means that another staff member who is a therapist but not an admin can review the notes of another therapist for a case they are not assigned to. There is no signature or review confirmation. 

  • Must Review and Approve All Notes

This means that when the staff signs an initial assessment, progress note, or treatment plan the supervisor assigned for review  is notified. The supervisor will then sign off on those documents awaiting review. The supervisor's and therapist's signature cannot be removed by anyone in the organization. Including admins. 

  • Must Review and Co-sign all Notes

This means that when the staff signs an initial assessment, progress note, or treatment plan the supervisor assigned for review  is notified. They will then sign off on those documents awaiting review. If changes need to be made then the admin can remove signatures from the initial assessment and progress note. The admin will still not be able to remove signatures from Treatment Plans or Addendums. 

Note: Custom forms are not included in supervisory review. 

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