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Bipolar follow-up note template
Designed for bipolar follow-ups where you need interval mood polarity, sleep and activity changes, mood-stabilizer response, and early warning signs—not a generic depression med check.
Template content
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Bipolar Follow-Up Note Interval Mood Course - Predominant polarity since last visit (euthymic, depressed, hypomanic/manic, mixed). - Symptom trajectory, episode duration estimates, and functional impact. - Sleep, energy, activity, impulsivity, irritability, racing thoughts, and goal-directed behavior. Early Warning Signs / Triggers - Sleep loss, substance use, schedule disruption, interpersonal conflict, or other identified triggers. - Prodromal signs patient or supports noticed. Medication / Mood Stabilizer Response - Current regimen with doses (lithium, anticonvulsants, atypical antipsychotics, adjuncts). - Adherence, missed doses, perceived benefit, adverse effects. - Recent levels/labs discussed (e.g., lithium, VPA, metabolic panel, TSH) when applicable. Mental Status Examination - Focused MSE with attention to elevated/irritable affect, pressured speech, thought form, and insight. Safety / Risk - SI/HI, impulsivity, reckless behavior, self-harm, and risk level with rationale. - Protective factors and means access if relevant. Assessment - Bipolar diagnosis specifier/status (e.g., currently euthymic, mild depressive episode) and treatment response. Plan - Medication adjustments with rationale; lab/monitoring schedule. - Sleep hygiene and relapse-prevention strategies; therapy coordination. - Safety planning and follow-up interval.
When to use this template
What makes the structure useful, and which visits it fits best.
Why this template works
Structural advantages for real documentation
Best for
Visit types and clinicians who use this format
- Tracks manic, hypomanic, mixed, and depressive features as distinct interval domains.
- Keeps mood-stabilizer levels, adherence, and metabolic monitoring visible.
- Surfaces early warning signs and sleep disruption before full episode relapse.
- Supports safety documentation during elevated or mixed states.
- 1Outpatient bipolar maintenance visits
- 2Mood stabilizer titration follow-ups
- 3Telepsychiatry bipolar check-ins
Example output shape
Illustrative excerpt of how a visit can land in this structure. Not a real patient record—review and edit every note before signing.
Interval Mood Course Mostly euthymic for 5 weeks after a brief hypomanic stretch in early month (3–4 days of reduced sleep need, increased spending). Past 2 weeks mood “steady 6/10,” no racing thoughts. Sleep 7 hours most nights. Medication / Mood Stabilizer Response Lithium 900 mg qHS (level 0.7 two weeks ago); lamotrigine 200 mg daily. Adherent. Mild tremor unchanged. No rash. Weight stable. Safety / Risk No SI/HI. Impulsivity improved since hypomanic interval. Risk low. Assessment Bipolar I disorder, currently euthymic, good response to lithium + lamotrigine. Plan Continue current doses. Recheck lithium and BMP in 3 months. Reviewed sleep protection and spending limits as early-warning plan. Follow up in 6 weeks or sooner if sleep drops below 5 hours for 2 nights.
How Wavo automates this
What the product actually does with your template.
2. Record or dictate
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3. Review and sign
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Put this template to work on your next visit
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