> For clean Markdown of any page, append .md to the page URL.
> For a complete documentation index, see https://docs.usebridge.com/llms.txt.
> For AI client integration (Claude Code, Cursor, etc.), connect to the MCP server at https://docs.usebridge.com/_mcp/server.

The *Note* resource contains the clinical documentation, associated with a single Service.

Services cannot be [billed](/documentation/concepts/services#billing) until a Note is successfully attached.

## Content

The content of the Note varies by partner and type of care being delivered.
Bridge's RCM team will coordinate with your clinical/operational team during onboarding, to align on the structure.
For many uses cases, it follows the standard SOAP format.

## Submitting a Note

After the delivery of care, the Note is submitted to Bridge via the [Create Note](/api/api-reference/notes/create-note) endpoint.

The `data` field contains the key/value pairs that operational teams have aligned on including.

The Note should be *signed* by the rendering Provider, and include a timestamp that they finalized the content.

### Required Fields

Required fields are defined during onboarding and may differ by service type.
If your template includes a telehealth disclaimer or specific clinical sections, ensure they are
present in every Note.

### Size and Formatting

Bridge does not enforce a strict Note size limit, but large payloads may be rejected by upstream
network limits. Keep payloads reasonable and avoid heavy HTML formatting when possible.

## Updates

The Note is immutable. Once submitted, it's considered *locked*, and cannot be modified or deleted.

If updates are required, this is done by submitting a [Note Addendum](/api/api-reference/notes/create-note-addendum) under the original Note.
Many EHR's are built around this workflow, and construct a distinct *addendum* that can be attached here.

Addenda can be submitted even after a Service is billable. This is the most common update flow.