Documents are the cornerstone of medical records and electronic records will require electronic documents. For systems to communicate, these documents will need to be able to be carried in electronic messages. Health Level Seven (HL7) is the most widely adopted set of standards for the transfer of electronic messages and, in Version Three (HL7 V3), there is a standard for the production of electronic documents. This standard is called Clinical Document Architecture, now in its second release (CDA R2). It may be carried by HL7 V3 or Version Two (HL7 V2) messages, but can also stand alone as a separate document outside of a message. This project describes the creation of a Procedure Note Implementation Guide, and as part of that, the construction of an endoscopy report example of a procedure note.