Objective: A note in the electronic health record documents the patient’s condition, signs and symptoms, providers’ objective and subjective examination findings, interventions, and plans of care. Thorough and accurate documentation creates and secures a historical record and may serve as a primary means of communication among members of the care team. Thorough and accurate notes are a professional responsibility and are critical to continuity of care. This chapter addresses necessary elements and common pitfalls, provides tools to support effective note-writing, and considers the influence of emerging technologies on the future of notes in the electronic record.