The Advanced SOAP template is CoVet’s most detailed SOAP structure. It is designed for teams that want a highly configurable medical record with separate fields for history, physical exam findings, assessment details, diagnostics, treatments, client communication, and follow-up planning.
This article explains each section, subsection, and element included in the Advanced SOAP template. Use it as a reference when deciding which elements to enable, which to turn off, and how to configure the template for your workflow.
Subjective
The Subjective section captures the chief complaint, prior history, and lifestyle context live.
Subsection 1: Visit framing (2 elements)
Sets up who is documenting the visit and why the patient was brought in today.
Attending DVM: pulls in the username of whoever generates the record. This is a programmatic insertion, not done by AI.
Presenting Concerns: captures why the patient was presented, from the client's perspective.
Subsection 2: History (11 elements)
This subsection captures the patient's history. It is designed to work in one of two modes, depending on your preference.
Mode A: Broken-out history (default)
Single Paragraph History is toggled off; almost every other element is toggled on. Information is routed to the appropriate element by topic.
Single Paragraph History: when on, summarizes the entire history given, regardless of topic. Off in this mode.
Historical Conditions: previous diagnoses, surgeries, and chronic conditions.
Diet and Appetite: what the patient eats and any appetite changes.
Drinking and Urination: water intake and urinary changes.
Vomiting, Diarrhea, Coughing and Sneezing: GI and respiratory complaints if mentioned.
Skin and Coat: dermatologic history.
Mobility: gait, stiffness, jumping, stairs, activity tolerance.
Current Medications: what the patient is currently on, including supplements.
Lifestyle and Risk Factors: indoor/outdoor, other pets, exposures, environment.
Travel History: recent travel relevant to infectious or regional disease.
Additional Information: catch-all for anything historical that does not fit one of the categories above. Nothing said in history gets dropped.
Mode B: Single Paragraph History
Some vets prefer a narrative paragraph instead of a broken-out history. In that case, toggle Single Paragraph History on and toggle nearly everything else off.
Objective
The Objective section captures the physical exam and any in-hospital findings. It is split into four subsections: vitals, emotional assessment, physical exam, and other objective data.
Subsection 1: Vitals (12 elements)
Mentation
Current Weight
Target Weight
Body Condition Score (Out of 5)
Body Condition Score (Out of 9)
Muscle Condition Score
Temperature
Heart Rate/Pulse
Respiratory Rate
Mucous Membranes
Hydration Status
Pain Score
Subsection 2: Emotional assessment (1 element)
Emotional Assessment: captures the patient's behavior during the visit. Oriented around the Fear Free concept of fear, anxiety, and stress (FAS). Captures a numerical FAS score when given, but also works without one, pulling in how the patient behaved, reactions to handling, whether pre-visit pharmaceuticals or pre-appointment sedation were used, whether treats were taken, and so on.
Subsection 3: Physical exam (14 elements)
Standard PE by body system. Most vets leave all 14 toggled on by default.
Eyes
Ears
Nose
Throat
Oral
Cardiovascular
Respiratory
Abdominal
Lymph Nodes
Integumentary
Neurologic
Musculoskeletal
Urogenital
Rectal
Subsection 4: Other objective data (2 elements)
Microchip: populates if a microchip was scanned, discussed, or implanted during the visit.
POC Diagnostics with Results Available: point-of-care diagnostics where a result is already available at the time of the visit. See the Diagnostics setup note in the Plan section below.
Assessment
The Assessment section has three versions of the assessment. Only one should ever be enabled at a time.
Subsection: Assessment (3 elements)
Problem List + DDx + Comments: the longest version. Lists the problems being assessed, differential diagnoses for each problem, and additional comments such as historical considerations, why one differential is more likely than another, and lab results pointing in a direction. If the Volunteer Differential Diagnosis feature is on, this element will also volunteer differentials the vet did not state aloud.
Problem List + DDx: the medium version. Problem list plus differentials or rule-outs, with no additional commentary. If the Volunteer Differential Diagnosis feature is on, this element will also volunteer differentials the vet did not state aloud.
Problem List Only: the shortest version. A bare list, for example "vomiting, diarrhea, urinary tract infection," with no differentials or comments.
Plan
Most elements in the Plan section are paired: a List Only version and a List + Related Discussion version.
Whether to use the List Only versions or the List + Related Discussion versions is a setup choice that shapes the entire Plan.
Setup choice: where does client discussion live?
Two valid setups, depending on whether you want discussion centralized or distributed:
Setup A: Centralized discussion. Use the List Only version of every paired element, then enable Full Client Discussion at the bottom. All discussions (vaccines, medications, diet) flows into the single Full Client Discussion block.
Setup B: Inline discussion. Use the List + Related Discussion version of every paired element. Pair this with Additional Discussion at the bottom, which only captures overflow.
Subsection: Plan (15 elements)
Paired elements (List + Related Discussion vs. List Only):
Vaccinations: List Only captures just what was given (for example, "Rabies, 3-yr SubQ; Lepto, 1-yr SubQ"). List + Related Discussion adds any conversation about booster schedules, adverse reactions, or vaccine rationale.
Pending Diagnostics: diagnostics ordered today with results not yet available.
All Diagnostics: every diagnostic from this visit, regardless of whether a result is back. See the Diagnostics setup tip below.
Medications and Treatments: what was prescribed, dispensed, or administered.
Diet and Feeding Recommendations: diet changes, feeding instructions, transition plans.
Standalone elements:
Time-stamped Case Update: most useful for emergency cases. Captures everything in chronological order using timestamps drawn from the transcript. It functions as a one-element Plan in itself.
Care Declined or Deferred: a dedicated callout for declined or deferred recommendations. Provided as an option for vets who want to call this out explicitly for medico-legal clarity.
Full Client Discussion: centralized discussion block. Pair with Setup A (List Only versions throughout).
Additional Discussion: overflow-only discussion block. Pair with Setup B (List + Related Discussion versions throughout). It will not repeat content already captured under a specific element above.
CoVet Disclaimer: a programmatically added sentence reading: "This document was generated with the assistance of CoVet AI to support accurate and efficient documentation." You can reword this in your label if you prefer different language.
Diagnostics Setup: Cross-Section Configuration
CoVet can differentiate between diagnostics where a result is already available and diagnostics where the result is still pending. How those two buckets get sorted is a setup choice that spans the Objective and Plan sections.
Setup 1: Results in Objective, pending in Plan
Objective: enable POC Diagnostics with Results Available.
Plan: enable one of the two Pending Diagnostics versions.
Diagnostics with results land in Objective. Everything still pending lands in Plan.
Setup 2: All diagnostics in Plan
Objective: turn off POC Diagnostics with Results Available.
Plan: turn off Pending Diagnostics and enable one of the two All Diagnostics versions.
Every diagnostic, whether the result is available or pending, appears together in Plan.