Managed templates Custom templates Custom template limits Example customization instruction Template best practices

Clinical note templates

Templates define the structure, sections, and formatting rules that the agent follows when generating clinical documentation. You must specify an output format by passing a configuration object to the noteTemplateSettings API parameter with every session. Ambient documentation supports two methods to specify the output format — managed templates or custom templates.

Managed templates

Ambient documentation provides seven pre-built note templates. The configuration object for managed templates, managedTemplate, specifies the template through the templateType parameter. The default template is HISTORY_AND_PHYSICAL.

Template	Description	Use case
HISTORY_AND_PHYSICAL (default)	Summaries for key clinical documentation sections	General physical health encounters
PHYSICAL_SOAP	Physical health focused SOAP format	Physical health encounters using SOAP structure
BEHAVIORAL_SOAP	Behavioral health focused SOAP format	Behavioral health encounters using SOAP structure
GIRPP	Progress-toward-goals format	Behavioral health — tracking patient progress
BIRP	Behavioral patterns and responses format	Behavioral health — documenting behavioral patterns
SIRP	Situational context of therapy format	Behavioral health — emphasizing situational context
DAP	Simplified clinical documentation format	Brief or focused encounters

HISTORY_AND_PHYSICAL sections

Section	Description
CHIEF COMPLAINT	Brief description of the patient’s reason for visiting the clinician
HISTORY OF PRESENT ILLNESS	Information on the patient’s illness, including severity, onset, timing, current treatments, and affected areas
REVIEW OF SYSTEMS	Patient-reported evaluation of symptoms across different body systems
PAST MEDICAL HISTORY	Previous medical conditions, surgeries, and treatments
PAST FAMILY HISTORY	Health conditions that run in the patient’s family
PAST SOCIAL HISTORY	Social life, habits, occupation, and environmental factors affecting health
PHYSICAL EXAMINATION	Clinician’s findings from physical examination of body systems and vital signs
DIAGNOSTIC TESTING	Results and interpretations of laboratory tests, imaging studies, and other diagnostic procedures
ASSESSMENT	Clinician’s assessment of patient’s health
PLAN	Clinician-recommended medical treatments, lifestyle adjustments, and further appointments

PHYSICAL_SOAP and BEHAVIORAL_SOAP sections

Section	Description
Subjective	The patient’s goals, experiences, and existing and past issues
Objective	Data and facts about the patient
Assessment	The clinician’s diagnosis of the patient’s situation
Plan	Clinician-recommended next steps in treatment, including future interventions and referrals

Note

PHYSICAL_SOAP is optimized for physical health documentation. BEHAVIORAL_SOAP is optimized for behavioral health documentation. Both share the same section structure.

GIRPP sections

Section	Description
Goal	The identified problem, challenge, or behavior to address through treatment
Intervention	The specific treatment, method, or technique used by the clinician
Response	How the patient responded to the intervention, including participation level and feedback
Progress	The clinician’s assessment of movement toward treatment goals
Plan	Clinician-recommended next steps in treatment, including future interventions, homework, and referrals

BIRP sections

Section	Description
Behavior	The problems the patient presents and their response to treatment
Intervention	The specific treatment, method, or technique used by the clinician
Response	How the patient responded to the intervention
Plan	Next steps in treatment

SIRP sections

Section	Description
Situation	The problem the patient presents and their goal for seeking therapy
Intervention	The specific treatment, method, or technique used by the clinician
Response	How the patient responded to the intervention
Plan	Clinician-recommended next steps in treatment

DAP sections

Section	Description
Data	The patient’s reasons for seeking treatment and information about the patient
Assessment	The clinician’s diagnosis of the patient’s situation
Plan	Clinician-recommended next steps in treatment

Custom templates

Ambient documentation uses a two-layer customization model: Base and Output Specification. These two layers are managed in a configuration object, customTemplate. The customTemplate configuration object contains two parameters: templateType sets the Base template and templateInstructions contains the Output Specification.

The Base (templateType) sets the organization structure of the clinical facts detected during the conversation. The following base templates are supported:

Base	Description	Use case
HISTORY_AND_PHYSICAL	Summaries for key clinical documentation sections	General physical health encounters
BEHAVIORAL_SOAP	Behavioral health focused SOAP format	Behavioral health encounters using SOAP structure
GIRPP	Progress-toward-goals format	Behavioral health — tracking patient progress
BIRP	Behavioral patterns and responses format	Behavioral health — documenting behavioral patterns
SIRP	Situational context of therapy format	Behavioral health — emphasizing situational context
DAP	Simplified clinical documentation format	Brief or focused encounters

Note

The custom-template base type list does not include PHYSICAL_SOAP. PHYSICAL_SOAP is available only as a managed template. If you pass it as a custom templateType, the request is rejected with a validation error.

The Output Specification object (templateInstructions) is organized as an array of instructions, with a sectionHeader that defines the section name and sectionInstruction that combines instructions and a template for that section.

Custom template limits

The following limits apply to custom templates.

Number of section instructions (templateInstructions, required)

Property	Value
Minimum	1 section instruction
Maximum	20 section instructions
What happens if you exceed it	A request with 0 sections, or with more than 20, is rejected. If you need more than 20 logical sections, consolidate related content into a single section instruction.

Each section instruction is also size-limited individually — see Section instruction below.

Section header (sectionHeader, required)

Property	Value
Type	String
Supported characters	Alphanumeric only (`A-Z`, `a-z`, `0-9`). No spaces, underscores, or punctuation. For example, use `ChiefComplaint` or `PhysicalExam`, not `Chief Complaint` or `Physical_Exam`.
Pattern	`^[a-zA-Z0-9]+$`

Section instruction (sectionInstruction, required)

Property	Value
Type	String
Maximum size	15 KB (15,360 bytes) per section instruction, measured on the UTF-8 byte length. The limit applies to each section instruction individually, not to the template as a whole.
Supported characters	The same set as encounter context (see Character support)
Pattern	+^[\p{L}\p{N}\s\*_\-#\[\]\.,:;!?'"`<>~/

Tip

Because the supported set includes {, }, [, ], and |, you can describe a structured output — such as a JSON object or a Markdown table — directly in a section instruction. When you do, state the exact keys or columns you want and instruct the model to return only that structure.

Customization instructions can include three types of directives:

Verbosity instructions — Control content conciseness or elaboration. Example: "Describe the chief complaint in 1 sentence or less."
Template usage instructions — Direct how the agent handles misalignment between the template and the encounter content. Example: "Follow the template exactly: if requested data is unavailable, write INFORMATION NOT FOUND."
Style instructions — Specify formatting, terminology, and reasoning requirements. Example: "Use numbered problems in the Assessment section."

Templates can be provided as text with placeholders, structured JSON schemas, or example previous notes.

Method	Description	Use when
Text template with placeholders	A template with section headers and placeholder fields (such as <chief_complaint>) that the agent fills from the encounter	You want precise control over section layout and content placement
Structured JSON template	A JSON schema defining fields, nesting, and per-field formatting rules	Your EHR requires structured data output rather than prose
Example previous note	A prior clinical note provided as a reference for the desired format and style	A provider wants notes that match their existing documentation patterns

Note

The service is stateless. To use a previous note as a style reference, your application must include it in the instructions for each session. The agent does not retain provider preferences across sessions.

Example customization instruction

The following example shows a customization instruction for a SOAP note using the customTemplate configuration object.


{
  "clinicalNoteGenerationSettings": {
    "noteTemplateSettings": {
      "customTemplate": {
        "templateType": "HISTORY_AND_PHYSICAL",
        "templateInstructions": [
          {
            "sectionHeader": "Subjective",
            "sectionInstruction": "You will be generating a SOAP note one section at a time, starting with the `S` section. Please use this template when generating the `S` section:\n<template>\nSUBJECTIVE:\nChief Complaint: <Brief statement, in patient's own words, if available>\nHistory of Present Illness: <Narrative description of current symptoms, onset, duration, quality, severity, timing, context, modifying factors, associated symptoms.>\nReview of Systems:\n• Constitutional: <fever, chills, weight changes, fatigue>\n• Cardiovascular: <chest pain, palpitations, shortness of breath>\n• Respiratory: <cough, dyspnea, wheezing>\n• GI: <nausea, vomiting, diarrhea, constipation, abdominal pain>\n• GU: <dysuria, frequency, urgency, hematuria>\n• Musculoskeletal: <joint pain, muscle weakness, back pain>\n• Neurological: <headache, dizziness, numbness, weakness>\n• Psychiatric: <mood changes, anxiety, sleep disturbances>\n• All other systems negative unless noted above Past Medical History: <List chronic conditions>\nPast Surgical History: <List previous surgeries with dates>\nMedications: <Current medications with doses>\nAllergies: <Drug allergies and reactions, or NKDA>\nSocial History: <Tobacco, alcohol, drugs, occupation, living situation>\nFamily History: <Relevant family medical history>\n</template>"
          }
        ]
      }
    }
  }
}

Template best practices

Well-designed templates produce clinical notes that consistently follow your intended structure. Apply the following practices when defining custom templates:

Define your note structure with named section headers. List each section of your desired note by name, using a consistent delimiter. The model uses these headers as structural anchors to place content in the correct location.
Use descriptive placeholders that explain what content belongs in each section. For example, Chief Complaint: <Brief statement in patient’s own words, if available>.
Enumerate expected subsections for multi-part fields. For sections that span multiple categories (such as body systems or problem lists), list them explicitly with representative values to indicate scope.
Handle missing information gracefully. Use phrasing like "if available" or "if applicable" within placeholders to signal that a section can be omitted when the encounter does not produce relevant content.
Test templates across visit types. A template that works for follow-up visits may not suit new patient encounters or wellness exams. Validate your templates against a representative sample of encounters before deploying broadly.

Warning Javascript is disabled or is unavailable in your browser.

To use the Amazon Web Services Documentation, Javascript must be enabled. Please refer to your browser's Help pages for instructions.

Document Conventions

Encounter context

Storage and outputs