---
title: Spravato session note Template & Example | Nextvisit
description: "REMS-aware esketamine session: pre/post vitals, two-hour observation, dissociation, sedation, and discharge criteria."
url: "https://nextvisit.ai/templates/spravato-session-note"
type: static
generatedAt: "2026-09-21T03:14:00.685Z"
---

Note template
# Spravato session note Template & Example

REMS-aware esketamine session: pre/post vitals, two-hour observation, dissociation, sedation, and discharge criteria.

Updated May 7, 2026

Every Spravato session needs pre and post vitals, a documented two-hour observation, dissociation and sedation assessment, discharge vitals, and a transportation plan. Generic SOAP misses that. Practices end up with a paper checklist and a second entry in the EHR.

Ships for Spravato-certified clinics. Works for 56 mg and 84 mg, induction and maintenance. Pre-dose vitals, dose, observation-interval vitals, CADSS-style dissociation screening, sedation, and discharge criteria each have their own fields.

```
Patient: [patient_name]    DOB: [dob]    Age: [age]
Date: [encounter_date]     Provider: [provider_name]    Monitor: [monitor_name]
REMS pharmacy: [pharmacy_name]    Visit number in series: [visit_number]
Treatment phase: induction (twice weekly) / maintenance (weekly or biweekly)

Pre-treatment
- Indication: treatment-resistant depression / MDD with suicidal ideation
- Concurrent oral antidepressant (drug, dose):
- Last dose date and time:
- Patient screening since last visit (BP, mood, SI, recent substance use, recent BP medication change):
- Pre-dose vitals (BP, HR, time):
- Pre-dose mood rating and PHQ-9 if collected:
- Informed consent on file and reaffirmed: yes / no
- Transportation arranged: yes / no
- NPO status for the morning: yes / no

Treatment
- Dose given: 56 mg / 84 mg
- Devices used and observed self-administration: yes / no
- Time of first device:
- Time of second device (if applicable):

Observation period (minimum two hours from last dose)
- 40-minute interval BP and HR:
- 90-minute interval BP and HR:
- 120-minute interval BP and HR:
- Dissociation observed (CADSS or clinical impression):
- Sedation observed (RASS or clinical impression):
- Adverse effects (nausea, headache, vertigo, BP elevation, anxiety):
- Interventions during observation:

Post-observation
- Final vitals before discharge (BP, HR, time):
- Mental status at discharge (alert, oriented, ambulating safely):
- Suicidal ideation reassessment:
- Dissociation resolved: yes / no
- Sedation resolved: yes / no
- Discharge criteria met per REMS: yes / no
- Released to (responsible adult):
- Transportation method (no driving for the rest of the day):

Assessment and plan
- Treatment response (interval since last session, depression scale change, functional change):
- Side-effect tolerability:
- Continue current dose: yes / no
- Dose adjustment recommendation:
- Next session scheduled:
- Continuation of oral antidepressant confirmed:
- Coordination with referring prescriber:
```

AriaMD captures the session as it runs. Pre-dose vitals, dose, and observation-interval vitals land in their own fields. Dissociation and sedation are tagged at the timestamps they occurred. Discharge language matches a REMS audit. The Spravato tag keeps the visit on the course view.

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