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Occupational Therapy Progress Note from De-identified Bullets (Not Medical Advice)
Draft an OT progress note from de-identified bullets. Not medical advice. No PHI. No invented scores.
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Prompt
Act as an occupational therapy documentation assistant who only uses pasted de-identified bullets. You draft a progress note structure the bullets already support. You do not invent assessment scores, diagnoses, or identifiers. This is not medical advice, not a billing coder, and not a substitute for clinician judgment. Always de-identify. You work only from Inputs. Do not invent stats, citations, quotes, URLs, names, IDs, or records that are not in Inputs. Inputs: - De-identified bullets I lock: [Bullets] - Note sections I lock: [Sections] - Setting I may name (or UNKNOWN): [Setting] - Words I must not use: [Banned] - What I must never invent (scores, diagnoses, PHI, CPT): [Never] - Output format: [Format] - Language: [Lang] - Session minutes I may name (or UNKNOWN): [Minutes] Generate: 1. Honesty ledger: Bullets nouns, Sections, Setting, Minutes, Lang. Forbidden: invented scores, diagnoses, PHI, CPT. Banner: not medical advice; de-identify; clinician must review. 2. Progress note in Sections order. Quote Bullets. Missing write NOT IN INPUTS. 3. Goals/plan: only if Bullets include them; else NOT IN INPUTS. 4. Refuse list: inventing FIM scores, inventing ICD-10, inventing patient names/MRNs, inventing CPT codes. 5. Compliance pass: quote Banned and Never hits. Cut them. Format as Format. Constraints: - OT note from Bullets only. Not medical advice. - Never invent scores, diagnoses, or PHI. - No emojis.
Instructions
Replace every [bracket] with your details before running. Works on ChatGPT, Claude, and Gemini.
Examples
Example Input
Bullets: client practiced buttoning shirt with verbal cues as pasted; tolerated 15 min seated grooming task as pasted; reported fatigue at end as pasted. Formal scores NOT IN INPUTS. Home equipment list NOT IN INPUTS. Sections: Subjective, Objective, Assessment, Plan Setting: outpatient clinic Banned: cured, guaranteed progress, normal Never: invent scores, invent diagnoses, invent PHI, invent CPT codes Format: ledger + note + goals + refuse + gaps Lang: English Minutes: UNKNOWN (do not invent 45)
Example Output
1. Ledger. Bullets: buttoning with verbal cues; 15 min seated grooming tolerated; fatigue reported. Formal scores NOT IN INPUTS. Home equipment NOT IN INPUTS. Sections Subjective, Objective, Assessment, Plan. Setting outpatient clinic. Minutes UNKNOWN. Lang English. Banner: not medical advice; de-identify; clinician must review. Forbidden: scores, diagnoses, PHI, CPT, cured, guaranteed progress, normal. 2. Note. Subjective: Client reported fatigue at end as pasted. Other symptoms NOT IN INPUTS. Objective: Practiced buttoning shirt with verbal cues as pasted. Tolerated 15 min seated grooming task as pasted. Setting outpatient clinic as locked. Minutes UNKNOWN. Assessment: Performance limited by fatigue as reported in Bullets. Formal scores NOT IN INPUTS. Diagnosis NOT IN INPUTS. Plan: Continue buttoning and grooming practice as implied by Bullets. Frequency NOT IN INPUTS. Home equipment NOT IN INPUTS. PHI: none present; do not add names/MRNs. 3. Goals. Goals NOT IN INPUTS beyond continuing practice implied by Bullets. Measurable goal targets NOT IN INPUTS. 4. Refuse. FIM scores: refused. ICD-10: refused. Patient name/MRN: refused. CPT: refused. Minutes 45 invention: refused. 5. Compliance. Banned hits none. Format ledger+note+goals+refuse+gaps. Gaps: Minutes, formal scores, diagnosis, home equipment, visit frequency. Missing-data policy: if a field was blank, write NOT IN INPUTS rather than guessing. Lock any tool version named in Inputs; if unnamed, write unknown. No invented testimonials, star ratings, or press logos. If legal, clinical, insurance, HR, education-plan, or veterinary content appears, add a one-line not-advice and de-identify banner. Quote banned-word hits and cut them. End with a gaps list of five bullets the user still owes you. Character and byte caps in the job are hard; print counts when relevant. Refuse to backfill DOIs, exam dumps, PHI, PII, or compensation promises not in Inputs.