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A Canadian telepsychology and virtual care note is an ordinary progress note with telepresence elements added: session modality, the client's physical location, consent to virtual care, an emergency plan naming local resources, and a technology-failure fallback. Canadian psychologists and psychotherapists write one after every video or telephone session. No college mandates a template; expectations come from provincial standards and the CPA telepsychology guidelines. Most run 200 to 400 words.
Psychologists, registered psychotherapists, social workers, and counsellors delivering virtual care in Canada
Treating clinician, the client on request, supervisors, college record reviewers, extended-health and federal payers
200 to 400 words · 10 to 20 minutes by hand (clinical team estimate)
Progress-note variant with telepresence elements (compare: telehealth therapy note, SOAP, DAP)
After every video or telephone session where the clinician and client are in different locations
Provincial college standards plus CPA telepsychology guidance (2023); no college mandates a template
A Canadian telepsychology and virtual care note is the ordinary clinical progress note for a session delivered by video or telephone, with a telepresence layer added: modality, both parties' locations, a consent reference, an emergency plan tied to the client's location, and a technology fallback. The national guidance behind it runs from the ACPRO Model Standards for Telepsychology (2011) to the current CPA Guidelines on Telepsychology, approved in June 2023, which define telepsychology as "a method of providing psychological services through electronic means" when the psychologist and client are not in the same physical location. Clinicians and payers also call it a virtual care note, teletherapy note, telehealth progress note, or, in Quebec, a télépsychologie or télépratique record.
The framing that carries this page: almost none of the note's contents are mandated. No Canadian college prescribes a telepsychology template, a field list, a note-completion deadline, a written consent form, or Canadian data residency; those are conventions. Even the foundational ACPRO Model Standards state that they "have no force outside of official adoption by a member jurisdiction," and Ontario adopted them only as a non-binding advisory. What is law: provincial health-information statutes (Ontario's PHIPA, Alberta's HIA, Quebec's privacy act as amended by Law 25), enforceable college record-keeping standards, and, most consequentially, the client-location rule codified by the ACPRO Memorandum of Understanding on interjurisdictional telepsychology (in effect 1 April 2024): in eight provinces and territories you need registration or a licence where the client is sitting. The note is where you show you checked. Two boundaries matter: the telehealth therapy note covers the US-facing session record with its place-of-service and modifier logic, and the standalone telehealth consent is the one-time agreement this note references session by session.
Psychologists write most of them, alongside registered psychotherapists, social workers, and counsellors seeing clients by video or phone; a 2017 survey cited in the CPA guidelines found 47 percent of Canadian psychologists already used technology to deliver care, and the pandemic made the virtual session routine. The setting is usually private practice, because provincial public health insurance rarely covers private-practice psychology; the readers are extended-health carriers, federal programs such as NIHB and Veterans Affairs Canada, workers' compensation boards, supervisors, and college reviewers. Use the virtual-care framing whenever the session is remote: an in-person progress note simply omits the telepresence elements, and a US-billed session adds the Medicare layer covered on the telehealth therapy note page. Telephone-only sessions count as telepsychology; record that the session was audio-only and why.
Header and modality. Client identifier, date, session number, service type, start and stop times, and the modality: secure video or telephone. If the session was audio-only, say so and note why. No Canadian rule requires naming the platform (convention); recording that a secure platform was used is prudent, and US Medicare billing needs the audio-only reason on the record. Pitfall: logging "telehealth" generically; when a payer or college asks whether video was used, a generic label answers nothing.
Locations and jurisdiction check. Where the client physically is for this session, where you are, and the conclusion: you are authorized to practise where the client sits. The field itself is convention (no Canadian regulation codifies it), but it evidences a law-level question: under the ACPRO MOU, eight jurisdictions including Ontario, BC, and Alberta require registration or a licence where the client is located, while Quebec, Nova Scotia, and New Brunswick regulate through your home registration. Pitfall: capturing an address at intake and never asking again; the rule turns on where the client is today, which is exactly what changes with snowbirds and students.
Identity, privacy, and setting. Identity verification (first session, new device, or new location), confirmation the client is in a private space, and who else is present with the client's agreement. The CPA guidelines suggest agreeing on a code word the client can use if the space stops being private (convention). Pitfall: assuming privacy; a client joining from a car, a kitchen, or a workplace changes what can safely be discussed, and the note should show you asked.
Consent to virtual care. A dated reference to the standing consent conversation (risks, benefits, technology, privacy limits) plus a session-level confirmation and anything that changed. Consent itself is law: Ontario's PHIPA s 18 and its provincial analogues govern it. Written form is not: verbal consent is valid everywhere in Canada, and no regulation sets a re-consent interval (both convention). Pitfall: treating a signed form as the finish line; the form proves one conversation happened once, and the note is what shows consent stayed live.
Emergency plan and local resources. A support person near the client, the local crisis line (9-8-8 in Canada), and the emergency department nearest to where the client actually is this session. This element is convention: no Canadian rule codifies it, but the CPA guidelines direct psychologists to discuss emergency procedures, local back-up assistance, and local emergency resources. Pitfall: an emergency plan built around the clinician's city; if the client joins from a cottage two hours away, every named resource is wrong.
Technology contingency. The agreed fallback if the connection fails (usually: you call the client's phone), and documentation of any failure and how contact resumed. Convention, from the CPA guidelines' direction to plan an alternate means of contact. Pitfall: no documented fallback; when the video drops mid-disclosure, the record must show what happened next, not leave a gap where risk information should be.
Clinical content. The progress note proper: the client's report, your observations including any limits the medium put on them, assessment against treatment goals, a risk statement, and a dated plan. Record-keeping content standards are enforceable: in Ontario the CPBAO Standards are deemed standards of the profession under O Reg 801/93. Pitfall: a complete telepresence checklist wrapped around a thin note; colleges discipline record-keeping and consent deficiencies, and the virtual layer does not substitute for clinical substance.
CANADIAN TELEPSYCHOLOGY / VIRTUAL CARE NOTE Client: ____________ Date: __________ Session #: ____ Service: [individual/couples/family] Start/stop: ______________ Modality: [ ] secure video [ ] telephone (audio-only; reason: ________) LOCATIONS AND JURISDICTION CHECK Client's physical location this session: ________________________________ Clinician's location: ___________________________________________________ Authorized to practise where the client is located: [ ] yes If client is outside your home jurisdiction, basis: _____________________ IDENTITY, PRIVACY, SETTING Identity confirmed: [ ] yes Private setting confirmed: [ ] yes Others present (with client agreement): _________________________________ CONSENT TO VIRTUAL CARE Standing consent on file: date ________ [ ] verbal [ ] written Reconfirmed this session: [ ] yes Changes discussed: __________________ EMERGENCY PLAN (for the client's location TODAY) Local support person and contact: _______________________________________ Local crisis line: 9-8-8 (Canada) Nearest emergency dept: _____________ Code word for compromised privacy: ______________ TECHNOLOGY CONTINGENCY If the connection fails, clinician will: ________________________________ Failure this session / how contact resumed: _____________________________ CLINICAL CONTENT Client report / session focus: __________________________________________ Observations (note any limits of the medium): ___________________________ Assessment and risk: ____________________________________________________ Plan and next appointment: ______________________________________________ Clinician signature/credentials: ______________ Date signed: __________
Free to use and share, no signup. The PDF includes a one-page cheat sheet with section-by-section pitfalls and a pre-sign checklist; the DOCX is the blank template, ready to adapt.
Scenario: an Ontario psychologist in Toronto sees an adult client with generalized anxiety disorder by secure video at the client's home in Kingston, Ontario. CBT, session 5. All details are fictional.
Client: D.B., 41 · Date: 08/12/2026 · Session: 5 · Service: Individual psychotherapy, secure video, 50 min · Start/stop: 14:02 to 14:52
Telepresence: Secure video session; connection stable throughout. Client location confirmed at the start: home office, Kingston, Ontario, unchanged from prior sessions. Clinician location: private practice office, Toronto, Ontario. Writer registered in Ontario (CPBAO); client in Ontario, so no additional authorization required. Identity verified at intake; same account and device today. Client alone, door closed, using headphones.
Consent: Verbal consent to virtual care documented 05/06/2026, covering risks, benefits, technology, and privacy limits. Reconfirmed today; no changes.
Emergency plan: Local support: sister S.B., about 10 minutes away, contact on file. Nearest emergency department confirmed for the Kingston address. 9-8-8 reviewed at intake. Code word in place if privacy is compromised.
Technology fallback: If video fails, clinician calls the client's phone on file. Not needed this session.
Client report: "Better than the spring, but review season is coming." Average anxiety 5/10, down from 7/10 at session 3. Practised paced breathing on 4 of 7 days; one prolonged worry episode Sunday, about 90 minutes, tied to a quarterly review. Sleep 6 to 7 hours. Denied suicidal ideation, self-harm urges, and substance use.
Observations: On camera: groomed, appropriately dressed, home office setting. Speech normal in rate and tone; affect mildly anxious, brightening when describing skills use. Engaged in agenda setting. GAD-7 completed by screen share: 10, down from 14 at intake. Video and audio quality adequate for observation; head and shoulders only in frame, so psychomotor observations were limited to what the frame showed.
Assessment and risk: Symptoms consistent with GAD, improving. Progress toward Goal 1 (reduce daily worry duration): client initiated a coping skill without prompting. Risk: denies ideation; no indicators observed on screen; routine monitoring continues. Virtual delivery remains suitable; no barriers noted.
Plan: Continue weekly CBT by video. Introduce worry postponement next session. Homework: thought records plus one scheduled 15-minute worry period daily. Re-administer GAD-7 at session 8. Next appointment 08/19/2026; client expects to join from the same Kingston location. Signed: R. Leduc, C.Psych., 08/12/2026.
This sample is fictional and for educational purposes. It does not describe a real patient.
Writing these after every session? BastionGPT drafts complete notes from bullets, dictation, or a transcript.
Generate a note from bulletsThe virtual care note is ordinary clinical-record content under provincial health-information law: clients can request it, colleges can review it in a complaint or practice review, and it carries none of the special segregation US psychotherapy notes do. The enforceable layer is your college's record-keeping standard, and the clocks genuinely differ: Ontario's CPBAO Standards expect records kept at least 10 years after the last clinical contact, or 10 years after a minor client turns 18, Alberta works on a 10-year framework, and Quebec's regulation sets a 5-year floor from the last professional service. Supervision is also enforceable: under the CPBAO Standards a supervisor "must co-sign all documents which may be reasonably relied upon" in decisions affecting client care, which reaches a provisional registrant's virtual session notes. For clients with elevated risk, the emergency-plan element of this note is a pointer, not a substitute: build and reference a full safety plan whose resources match wherever the client joins from.
The payer layer is policy, not law, and in Canada it is fragmented. Extended-health carriers such as Sun Life, Manulife, and Canada Life reimburse registered providers practising within scope and warn that claims failing documentation standards can be delayed or denied; NIHB covers up to 22 hours of counselling per eligible client per calendar year (more case by case) from providers in good standing with a legislated regulator, with virtual sessions eligible on secure platforms; Veterans Affairs Canada, WSIB, and the workers' compensation boards each set their own record rules. None of them prescribes a note format: the format is a convention, the content is the requirement. If your caseload crosses the border, the US layer is different in kind: place-of-service and modifier rules drive Medicare claims, behavioral health telehealth (including audio-only to the home) is a permanent Medicare benefit, and a Canadian licence does not authorize practice into a US state; PSYPACT requires a US home licence, so it is not a workaround for Canadian registrants.
Canada's enforcement picture has a distinctive shape: as of mid-2026 there is no widely reported Canadian psychology-college discipline decision turning specifically on telepsychology-note deficiencies as the sole ground. Record-keeping and consent deficiencies are recurrent discipline themes, with telepractice appearing as context rather than the charge, and payer review by carriers, NIHB, and Veterans Affairs Canada focuses on provider eligibility, scope, and record adequacy. The US shows what concentrated scrutiny looks like: the HHS Office of Inspector General's telehealth integrity review (OEI-02-20-00720, September 2022) flagged 1,714 of roughly 742,000 telehealth-billing providers as high risk, with $127.7 million in Medicare fee-for-service payments, and in July 2022 the Department of Justice charged 36 defendants in telemedicine schemes alleging more than $1.2 billion in fraud. The BastionGPT Clinical Advisory Board sees the same errors most often in Canadian telepsychology and virtual care note reviews:
| Aspect | Canada | United States | Australia |
|---|---|---|---|
| Status | No mandated template; college record-keeping standards are enforceable (Ontario's CPBAO Standards are deemed standards of the profession under O Reg 801/93), while the CPA telepsychology guidelines (2023) and ACPRO model standards are guidance unless a college adopts them | Telehealth billing is governed by regulation and payer policy (42 CFR 410.78); behavioral health telehealth, including audio-only to the home, is a permanent Medicare benefit | Ahpra telehealth guidance expects clear, accurate records of each consultation; MBS telehealth determinations govern billing |
| Terminology | Telepsychology note, virtual care note; télépratique or télépsychologie in Quebec | Telehealth progress note, teletherapy note | Telehealth consultation note, case note |
| What changes | Registration where the client is located (the ACPRO MOU's three-way split), a per-session location check, and an emergency plan local to the client | Place-of-service codes (02 vs 10), modifiers 93, 95, and FQ, and a recorded reason when audio-only is used; patient and clinician generally both in the US | Referral chain under Better Access; the 12-month prior-relationship rule binds the referring GP, not the psychologist, and any eligibility exemption used must be recorded in the clinical notes |
| Retention | Provincial: Ontario expects 10 years after the last contact, or 10 years after a minor client turns 18; Alberta works on a 10-year framework; Quebec's floor is 5 years from the last professional service | No federal patient-chart retention rule; HIPAA's 6-year rule covers required documentation such as policies, and state law governs charts | 7 years from last contact and until age 25 for minors, statutory in NSW, Victoria, and the ACT; best practice elsewhere |
The clinical note travels; the regulatory layer does not. Before a cross-province or cross-border session, the live questions are whether you may practise where the client sits, which college's retention clock applies, and what the payer expects to see. The specifics move (the ACPRO MOU was updated in October 2025, and Yukon regulated psychology after it was drafted), so re-check your college's guidance and the MOU annually.
BastionGPT is specifically trained, tuned, and clinically tested on Canadian telepsychology and virtual care notes.
See how clinicians use it day to day on the AI therapy notes page.
Many BastionGPT users report saving more than 90 minutes per day on documentation.
HIPAA-compliant with a signed BAA on every plan. Your data is never used to train models. BastionGPT drafts, you review and sign.
No Canadian regulation makes the client's location a mandatory note field, so the field itself is convention. It earns its place because it evidences a question that is law: whether you are authorized to practise where the client is sitting, which is the rule most provinces apply. Confirm the location at the start of each virtual session and record it in one line; the sessions where it matters are exactly the ones where the answer changed.
It depends on the province. The ACPRO Memorandum of Understanding (in effect 1 April 2024) codifies a three-way split: eight jurisdictions (BC, Alberta, Saskatchewan, Manitoba, Ontario, PEI, Newfoundland and Labrador, and the Northwest Territories) require registration or a licence where the client is located, and most offer a Limited Telepsychology Practice certificate, Ontario's running up to 12 months. Quebec, Nova Scotia, and New Brunswick regulate through your home registration, and Yukon is not a signatory. The split is also profession-specific: CRPO "does not require practitioners who reside in another jurisdiction to become registered" to see an Ontario psychotherapy client, the opposite of the psychology position in the same province.
No, nowhere in Canada. Ontario's PHIPA s 18 and its provincial analogues permit express or implied, verbal or written consent, and no regulation sets a re-consent interval. What matters is the record: the date and mode of the consent conversation, the risks and technology discussed, and a session-level confirmation in the note. The standalone telehealth consent is the document this note references.
Treat the two cases differently. Inside Canada, apply the three-way split: a student spending term in an ACPRO-MOU province needs you to hold at least a limited telepsychology authorization there, while Quebec, Nova Scotia, and New Brunswick accept your home registration. Into the US, generally no without authorization from the destination state: US practice is governed by the client's location, a Canadian licence does not carry, and PSYPACT requires a home licence in a US compact state, so it is unavailable to Canadian-licensed psychologists. Some state boards offer narrow temporary or consulting exceptions; check before the client travels.
The same as the underlying progress note plus a short telepresence block: most run 200 to 400 words and take 10 to 20 minutes by hand. No Canadian psychology college sets a note-completion deadline or a length rule; the enforceable standard is contemporaneous, accurate, complete records. When the telepresence facts are stable, a few lines confirming location, consent, and the emergency plan carry the layer.
The clinical core is identical; the wrapper changes with the regulatory layer. The telehealth therapy note page covers the US-facing record, where place-of-service codes, modifiers, and audio-only justifications drive Medicare claims. The Canadian note leads with the registration question, provincial retention, and a payer set of extended-health carriers and federal programs. Australia's telehealth layer sits under Ahpra's telehealth guidance, and its multidisciplinary coordination record is the separate MBS case conference note.
Four things, all anchored to where the client is that day: a local support person who can physically reach them, the local crisis line (9-8-8 anywhere in Canada), the nearest emergency department, and an agreed code word the client can use if the space stops being private. No Canadian rule codifies the element; it is convention driven by the CPA guidelines, which direct psychologists to discuss emergency procedures and local back-up before care begins. Rebuild the plan whenever the client's location changes.
No. Extended-health carriers such as Sun Life, Manulife, and Canada Life reimburse when the provider is registered with a recognized provincial regulator and the service is in scope, and they warn that claims failing documentation standards can be delayed or denied. NIHB covers up to 22 hours of counselling per eligible client per calendar year, with more available case by case, on secure virtual platforms; Veterans Affairs Canada and the workers' compensation boards publish their own rules. All of this is payer policy: the format is a convention, the content is the requirement.
Give it bullets, a dictation, or a session transcript and it drafts the full virtual care note: the telepresence layer and the clinical content underneath it. Before you sign, it checks the elements a college reviewer or payer looks for: the client's location this session, the consent reference, a local emergency plan, the technology fallback, and a risk statement. BastionGPT is HIPAA-compliant with a signed BAA on every plan, and your data is never used to train models.
Educational content, not legal or billing advice. Sample notes are fictional. Follow your organization's policies and your board, payer, and jurisdiction requirements.