S
Subjective
Ongoing lower back stiffness, worse after sitting. Wants to return to lifting at the gym.
The SOAPR format · a non-standard variant
The SOAPR note:
The SOAPR note:
SOAP, plus a
Response — with a caveat.
SOAPR appends a fifth section for the patient's Response to treatment. It's an intuitive idea — but unlike SOAPE, SOAPIE or SOAPIER, "SOAPR" isn't a recognised standard, so it's worth knowing the properly established alternatives.
S · O · A · P · R — Response (informal)
Lower back pain · treatment session•MANUAL THERAPY•SOAPR
O
Objective
Reduced lumbar flexion, tender paraspinals L4–L5. Neural tests negative.A
Assessment
Non-specific mechanical low back pain, movement-limited.P
Plan
Soft-tissue release, graded lumbar mobilisation, home mobility routine. Review in 1 week.R
Response
Tolerated treatment well. Immediate easing of stiffness and +15° flexion post-session. No aggravation; happy to continue.
Read this first
"SOAPR" isn't a recognised standard
Be straight about this. The widely documented SOAP extensions are SOAPE, SOAPIE and SOAPIER — you'll find those in textbooks, clinical references and professional guidance. "SOAPR", by contrast, barely appears in authoritative sources; where it does turn up it's usually informal, and sometimes conflated with "SOAPER". So treat it as a convenient shorthand, not an established format.
Where clinicians do use SOAPR, the R means Response — the patient's reaction to the treatment delivered. That's a genuinely useful thing to record. The catch is only the label: if you want the same idea in a properly standardised format, you have good options.
The idea behind SOAPR is sound. The acronym just isn't the one the field standardised on.
Use these instead
Where "Response" is genuinely standard
If capturing the patient's response is what you're after, these established formats already have a home for it.
DAR
DAR — Data, Action, Response
Nursing "focus charting"
Here the R is Response by design — the patient's reaction to the action taken. This is the standard format built around documenting response.
BIRP
BIRP — Behavior, Intervention, Response, Plan
Behavioural health · counselling
Foregrounds the intervention delivered and the client's Response to it. The recognised choice in mental-health and substance-use settings.
SOAPIER
SOAPIER — the full SOAP extension
Comprehensive nursing charting
Adds Intervention, Evaluation and Revision. Note the difference: in SOAPIER the patient's response is captured under Evaluation, and the R is Revision — a change to the plan, not the response.
The concept
Response, Subjective and Evaluation — three different things
Whatever acronym you use, keeping these straight is what makes the note precise.
Subjective is the story the patient brings into the session. Response is how they reacted to the treatment during it — immediate, in-room: did they tolerate it, was there immediate change, any adverse reaction? Evaluation (in a SOAPE or SOAPIE note) is your longer-view judgement of whether the overall plan is working across visits. Same encounter, three distinct lenses: before, during, and over time.
Subjective is what they walked in with. Response is what the treatment did. Evaluation is whether the plan is working.
Keep reading
Related formats
Common questions
SOAPR notes, answered
Is SOAPR a standard note format?
No. SOAP, SOAPE, SOAPIE and SOAPIER are the documented SOAP-family formats; "SOAPR" barely appears in authoritative sources and is best treated as informal shorthand for appending the patient's Response. For a properly standardised way to record response, use DAR or BIRP.
What does the R in SOAPR stand for?
Where the term is used, R means Response — the patient's reaction to the treatment delivered. Don't confuse it with SOAPIER, where the R is Revision (a change to the plan).
What's the difference between Response and Revision?
Response is what happened to the patient — how they reacted to treatment. Revision is what the clinician changed in the plan afterwards. In SOAPIER these are separate steps: Evaluation captures the response, Revision captures the plan change.
So which format should I actually use?
If you want to record the patient's response in a recognised format, DAR (nursing) or BIRP (behavioural health) are purpose-built for it. If you're documenting a course of care, SOAPE or SOAPIE. See the full comparison.
Whatever format you use, keep it structured.
SOAP Notes structures your dictation into the framework you choose — free to start, private on your device.
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