I thought to Wayne's reply, and how about this? To make a confidential note, create a new, blank note. Put the information under the confidential tab, and don't enter anything else. Set a flag for Confidential note, so when you bring up the patient, it will show the flag, and you can look for (apparently) blank notes in the past encounters section. It's clumsy, I don't know how you will handle insurance billing and superbills, but it is SOMETHING anyway.