A consultation is the core clinical workflow in Lupa — it's where a vet or nurse examines a pet, records findings, prescribes treatment, orders diagnostics, and bills for services. Whether it's a routine vaccination, a sick-pet triage, or a post-surgical follow-up, every consultation flows through the same appointment details page with clinical notes, medical highlights, diagnostics, invoicing, and reminders all in one place.

How to Run a Consultation — Step by Step

Step 1: Open the Appointment

Navigate to the appointment in one of three ways:

From the Calendar — left click the appointment on your calendar view to see an overview then click 'Open Appointment' or right click and click 'Open' from the menu. The appointment opens on its details page.
From the Appointments list — click any row in the appointments table to open it.
From a Pet or Client profile — find the appointment in the pet's timeline or the client's appointment history and click the title of it. The appointment details page opens in a two-panel layout: the main content area on the left with a navigation bar at the top to take you to each section, and the clinical notes area on the right.

💡 You can also right-click an appointment on the calendar to see a context menu with quick actions — including opening the details page, changing the status, or starting the consultation directly.

Step 2: Start the Consultation

When the pet is in the consult room and you're ready to begin:

Click the status action button at the top right of the appointment (or within the context menu). You can also right click on the appointment itself and select "set status".
The appointment status changes to In Progress. The default appointment status flow is:

Status	What it means
Requested	Appointment booked but not yet confirmed by the practice (e.g. online booking awaiting approval)
Confirmed	Appointment confirmed — the client is expected at the scheduled time
Checked In	Client and pet have arrived and checked in at reception
In Progress	The consultation is actively happening — the vet or nurse is with the patient
Ready for Checkout	Clinical work is done — the pet is waiting at reception for payment and discharge
Completed	Payment taken and the appointment is fully closed

You can add additional statuses to this list.

Step 3: Review Pet Details and Medical History

Before examining the patient, review their history using the key sections below:

Pet Details — view the pet's species, breed, age, weight, sex, neutered status, microchip number, and any alerts or flags. Click the weight figure in the top bar to open the pet's full weight history and record a new weight.
Medical Highlights — a quick-reference summary of active diagnoses, vaccination history, parasite prevention records, and current prescriptions.
History — the full chronological history of all appointments, medical events, and clinical records for this pet

Step 4: Record Clinical Notes

Type your clinical findings, examination notes, and plan into the** text editor or use the AI consult summary**.
The Clinical Notes section is always visible on the right side of the page.
Use formatting tools (headings, bold, lists, links) to structure your notes clearly.

💡 Notes auto-save every few seconds — you don't need to click a save button. If your browser crashes or you accidentally navigate away, your notes will be there when you come back.

You can also click view notes history to see previous versions.

If Lupa Notes is enabled for your practice, a mic button appears in the top-right corner of the Clinical Notes panel. Click it to start recording the consultation audio. When the recording finishes, Lupa generates a summary and appends it directly into your clinical notes — separated from anything you've already typed. You can edit the result freely. A floating bar remains visible at the bottom of the screen while a recording is in progress, so you can see its status from anywhere in the app.

If you try to switch to a different practice location while a recording is active, Lupa will ask you to confirm — switching cancels the current recording. You can choose to keep recording or proceed with the switch.

You can set up your own templates for the AI summary in Settings > Templates to produce personalised summaries.

Step 5: Add Items to the Invoice

Click Plan & Invoicing in the sidebar to view the current invoice.
Click Add Item to search for services, products, or bundles.
Select items, adjust quantities, and apply any discounts.
Produce a prescription for any POM-V medications (see step 6)
Items are added to the invoice immediately. The invoice section shows all billable items for this appointment — services performed, products dispensed, and any subscription plan allowances that have been applied. Once finished adding items, click Update Invoice to save your changes. If the consultation is still in progress, a Finish & Exit button also appears in the invoice footer — click it to mark the appointment as ready for checkout and leave the invoice in one step, without scrolling back to the top of the page.

Step 6: Prescribe Medications

Once you have added the medication to the invoice (as in step 5)
Select the medication and fill in the prescription details by clicking the small prescription icon that appears on the invoice line item. Here you can add dosage, frequency, duration, quantity, and dispensing instructions.
When billing for a dispense, the action button shows Issue Dispense the first time, and Issue Repeat for any subsequent dispenses. Choose whether to Save and Print Prescription Label or create a written prescription for the client to collect later.
Once added to the invoice, a Prescription added to invoice confirmation appears with a View Invoice link. Click the link to jump straight to the invoice, or stay on the current page to issue further repeats.

The prescription is recorded against the pet's file and can be found in the prescription section of the pet file. If you change the number of items dispensed, this automatically updates the invoice with stock correctly adjusted.

If the invoice is still open for editing when you add a prescription to it, Lupa saves the invoice automatically before adding the prescription — you don't need to close or save the invoice manually first.

Printing all dosage labels at once — when an invoice contains more than one prescribed medication, a prescription icon button appears in the invoice action bar. Click it to print all dosage labels as a single print job (Print All), or use the arrow next to it to choose Download All and save a combined PDF instead. This saves you from printing each label individually. The button only appears if you have permission to update prescriptions.

For detailed prescription workflows including repeat prescriptions, dosage labels, and client notifications, see the dedicated prescriptions article.

Step 7: Order Diagnostics (If Needed)

Click Diagnostic Tests in the sidebar.
Choose the Lab or Imaging tab depending on the test type.
Create a new order by selecting the test, entering clinical details, and submitting. Lab orders integrate with connected laboratory providers (IDEXX, Zoetis) if your practice has those integrations configured. Results flow back into the appointment/pet file automatically.

Step 8: Finish the Consultation

When your clinical work is done:

Change the status to 'Ready for Checkout' or 'Completed' at the top of the page depending on your practices desired flow. The appointment now appears as "Ready for Checkout" on the calendar and in the appointments list, signalling to reception that the client can be processed for payment.

Step 9: Complete and Take Payment

Reception handles this final step:

Click on the appointment the appointment (it's marked Ready for Checkout).
Review the invoice and click 'Add item' if you want to invoice something else.
Change the status of the appointment to **Completed **and an **Add Payment **will appear at the bottom of the invoice section. You can also do this in one step by right clicking on the appointment from the calendar page, click Complete & Pay and process the payment.
Once payment has been taken and allocated you are finished with the appointment.

⚠️ Completed appointments are financially locked. Once an appointment is completed, the associated invoice is locked and cannot be edited. Make sure all items are correct before completing. If you need to make changes after completion you will need to change the status back to 'Ready for Checkout', this action is behind a permission flag.

The Consultation View — Section by Section

The appointment details page organises clinical information into distinct sections, accessible from the left sidebar:

Section	What it contains
Appointment Details	Booking notes (internal staff notes about the appointment), client notes from the pre-appointment questionnaire, appointment time, assigned staff, and appointment type
Appointment Notes	Rich text clinical notes with auto-save. Includes note history and AI consult summary if Lupa Notes is enabled
Pet Details	Species, breed, age, weight history, sex, neutered status, microchip, insurance, and any pet alerts or flags. Click the weight figure in the top bar to open the full weight history or add a new weight reading.
Medical Highlights	Quick-reference view of active diagnoses, vaccination records, parasite prevention history, and current prescriptions (vet stores only)
Pet Timeline	Full chronological history of all appointments, medical records, and clinical events for this pet across all locations
Pet Documents	Files and documents associated with the pet — uploaded lab reports, referral letters, consent forms, and images
Diagnostic Tests	Lab and imaging orders for this appointment. Two tabs (Lab and Imaging) if both are enabled. Results appear here when they come back from integrated providers
Plan & Invoicing	The invoice for this appointment — all billable items, prices, discounts, subscription plan allowances, and payment status
Appointment Actions	Status history and change controls. View who changed the status and when with the the small "i", or manually change the status if needed

Tips for Efficient Consultations

✅ Best practices from practices that run Lupa:

Check Medical Highlights before examining — knowing the pet's active diagnoses, vaccination status, and current medications avoids duplicate treatments and catches overdue preventives
Write notes as you go — auto-save means you can type during the exam rather than reconstructing from memory afterwards
Use the reception message when finishing — a quick note like "needs dental estimate" or "book blood test next week" saves a trip to the front desk
Add invoice items during the consultation — adding products and services as you use them means the invoice is ready when the client reaches reception
Set reminders before finishing — it's easy to forget a booster reminder once you've moved on to the next patient
Use keyboard shortcuts — press Ctrl+B to toggle the sidebar for more screen space when writing notes
Review the pet timeline for new patients — transferred or referred pets may have history from other clinics in the system

How does auto-save work for clinical notes?

Lupa saves your appointment notes automatically every few seconds while you type. There is no save button — your changes are persisted in real time. If your browser crashes, your internet drops, or you accidentally navigate away, the notes will be there when you return. The last-saved state is always what the rest of the team sees.

How does auto-status change work?

If your practice has enabled auto-status change, Lupa detects when you open an appointment near its scheduled time (within a 30-minute window before or after). It prompts you to move the status forward — for example, from Checked In to In Progress. You can accept or dismiss the prompt. This feature requires that a vet is assigned to the appointment.

Troubleshooting

Problem	Solution
I can't change the appointment status	Check that you have the correct permissions for appointment management. Some status transitions require specific roles — ask your practice manager to review your permissions in Settings > Roles & Permissions.
Clinical notes appear blank after I typed them	Auto-save requires a stable internet connection. If you lost connectivity while typing, your notes may not have saved. Check your connection and try refreshing the page — the last successfully saved version will load.
AI Consult Summary not appearing	Lupa Notes (AI Scribe) must be enabled for your practice and a recording must have been completed for this appointment. Check with your practice manager if you expected to see AI notes.
Can't add items to the invoice	If the appointment is already Completed, the invoice is financially locked. You'll need to create a new invoice or credit note to make changes. Check the appointment status first.
Diagnostic results not showing	Lab results depend on the integration with your lab provider (IDEXX, Zoetis). Results may take time to process. Check the Diagnostic Tests section and refresh if the results were recently submitted.

Frequently Asked Questions

Can multiple staff members work on the same consultation?

Yes. Multiple staff can have the same appointment open simultaneously. Notes auto-save independently — the most recent save wins. If two people are typing notes at the same time, coordinate to avoid overwriting each other's work. Invoice items and diagnoses are added as separate records and don't conflict.

Can I go back and edit a consultation after it's completed?

You can still view the appointment and its notes after completion, but the invoice is financially locked. Clinical notes can be amended after completion for record-keeping, but invoice changes require a credit note. Check your practice's policy on retrospective note amendments.

What's the difference between Appointment Notes and the AI Consult Summary?

Appointment Notes are the clinical notes you type manually (or edit after AI generation). If your practice has Lupa Notes enabled, recording the consultation audio generates a summary that is appended directly into your clinical notes — you can then edit it like any other text. If your practice uses the earlier AI Consult Summary feature instead, the summary is generated separately and you can review and copy it into your notes.

Do I have to follow the status flow in order?

You can skip statuses if needed — for example, moving directly from Confirmed to In Progress if the client walks straight into the consult room. The recommended flow (Confirmed → Checked In → In Progress → Ready for Checkout → Completed) gives the best visibility to the whole team, but Lupa doesn't force a strict sequence.

What happens if a client doesn't show up?

Change the appointment status to No Show. This records that the client was expected but didn't attend. No Show appointments don't require invoice completion and remain visible in the pet's timeline for record-keeping.

Can I cancel an appointment that's already In Progress?

Yes, you can change the status to Cancelled from any pre-completion state. If items have already been added to the invoice, you'll need to handle the invoice separately (remove items or void it) before or after cancelling.

Running a consultation