> ## Documentation Index
> Fetch the complete documentation index at: https://help.elationhealth.com/llms.txt
> Use this file to discover all available pages before exploring further.

# Visit Notes

> How visit notes are modeled in the hosted database: the note record, its content, and how it relates to patients, bills, orders, and documents.

A visit note is Elation's record of a clinical encounter. In the hosted database each note is modeled as two tables: a record for the note itself and a set of rows for its content.

* **`visit_note`**: one row per visit note, holding the note's metadata (patient, practice, author, sign-off, and timing).
* **`visit_note_bullet`**: one row per line of content within a note, joined to its note by `visit_note_bullet.visit_note_id = visit_note.id`.

For the full column list of every table mentioned here, see the [hosted database schema reference](/articles/hdb/where-can-i-see-what-data-is-available).

## Note content

A note's content is stored as bullets in `visit_note_bullet`. Each bullet has:

* a **`category`** naming the section it belongs to (Reason, HPI, Assessment, Plan, Orders, and so on),
* a **`sequence`** giving its order within that section, and
* an optional **`parent_bullet_id`**, since bullets can be nested under a parent.

A bullet carries its content in one of two ways. Most bullets hold **typed prose** directly in `text`: the narrative a clinician writes in sections like Reason, HPI, Assessment, and Plan. Other bullets instead **reference a separate record** (a placed order, an attached or referenced document, or a problem-list item); their `text` is empty because the content lives in that linked record rather than on the bullet.

## How visit notes relate to other data

Visit notes connect to the wider data model through these relationships:

| Related data                                                    | Relationship                                                                                                                                                                                                                                        |
| --------------------------------------------------------------- | --------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| **Patient**                                                     | `visit_note.patient_id` → `patient.id`                                                                                                                                                                                                              |
| **Authoring / signing user**                                    | `visit_note.physician_user_id`, `signed_by_user_id`, `created_by_user_id` → `user.id`                                                                                                                                                               |
| **Bills**                                                       | `bill.visit_note_id` → `visit_note.id`. See [Visit Notes and Bills](/articles/hdb/visit-notes-and-bills).                                                                                                                                           |
| **Document tags**                                               | `visit_note_document_tag.visit_note_id` → `visit_note.id`                                                                                                                                                                                           |
| **Orders** (medication, lab, referral, and other placed orders) | Orders are their own documents, linked to the **patient** rather than joined to the note. Query them by patient in [Medication Orders](/articles/hdb/med-orders), [Lab Orders](/articles/hdb/lab-orders), and [Referrals](/articles/hdb/referrals). |
| **Other referenced documents** (lab reports, attachments)       | The link between a bullet and the document it references is not exposed in the hosted database. Where the content has its own patient-level table (such as `lab_result`), query it by patient; otherwise it is not available through the note.      |

## Reading a note's content

This returns every content line for a single note, in display order:

<CodeGroup>
  ```sql sql theme={null}
  select
      b.visit_note_id
    , b.category
    , b.sequence
    , b.text
  from visit_note_bullet b
  where b.visit_note_id = <visit_note_id>
    and b.is_deleted = false
  order by b.category, b.sequence;
  ```
</CodeGroup>

Bullets that reference a separate record (such as placed orders) return empty `text`; retrieve that content from the related tables described in [How visit notes relate to other data](#how-visit-notes-relate-to-other-data).

*If you have any questions about this topic please reach out to [Elation Support Portal](/articles/support-portal-introduction) with the subject line HDB - \<your\_question>*