Last updated: August 28, 2026
These Terms govern your use of FerriScribe, an open source, local-first desktop application for recording clinical encounters and generating SOAP note drafts. FerriScribe is developed and maintained by the FerriScribe open source project ("the project"). Your use of FerriScribe means you accept these Terms. If you do not accept, do not use the software.
These Terms are written in plain English so a practising physician can read and understand them in roughly five minutes. Where we refer to law, we cite the specific statute or standard.
1.1 FerriScribe is a software tool. It records audio from your clinical encounters, transcribes that recording, and produces a draft SOAP note. It does not make clinical decisions, it does not diagnose, and it is not a medical device.
1.2 You remain the treating physician. Every output from FerriScribe is a draft that you must review, edit (if necessary), and approve before it becomes part of any patient record. The legal responsibility for the content of every medical note, referral letter, or other clinical document that enters a patient's chart is yours alone.
1.3 FerriScribe does not replace clinical judgment, professional accountability, or the obligations set out by the College of Physicians and Surgeons of British Columbia ("CPSBC"), including the CPSBC "Ethical Principles for Artificial Intelligence in Medicine."
2.1 Local-first by design. FerriScribe is architected so that, by default, audio recording and transcription happen on your device (your computer). No audio, transcript, or note leaves your machine unless you choose to use a cloud model (see 2.2). This is a design property of the software, not a service promise.
2.2 Optional cloud models. Some transcription or language models may be made available through third-party cloud services. If you select a cloud model, the audio or text you submit may be transmitted to that third party solely for the purpose of generating a transcription or draft note. The project does not operate or control these third-party services; you should review their terms and privacy policies before enabling a cloud model.
2.3 You are responsible for choosing whether to use a local or cloud model and for ensuring that your choice is consistent with any applicable privacy policy of your practice, your College's guidance, and (if you work in a hospital or facility) your facility's policies.
3.1 Patient consent. Before recording any clinical encounter with FerriScribe, you must obtain and document the patient's consent to be recorded. The CMPA (Canadian Medical Protective Association, "AI Scribes: Answers to frequently asked questions," Dec 2023 / revised Dec 2025) and the CPSBC both state this requirement clearly. You should explain to the patient, in understandable language, that:
(a) an audio recording will be made of the encounter;
(b) the recording will be used by FerriScribe to draft a medical note;
(c) you will review and, if necessary, edit that draft before it enters the patient's record; and
(d) there are inherent privacy risks associated with digital processing, and AI may produce inaccurate or biased entries.
You must document this consent discussion in the patient's medical record and keep any consent form if you use one.
3.2 Review and approval. You must review every AI-generated note, transcript segment, or suggestion produced by FerriScribe before it becomes part of a patient's medical record, EMR entry, or any other clinical document. You are responsible for correcting errors, omissions, or bias. The CMPA warns: "A patient who is injured because of an error in an unreviewed chart entry may launch a hospital complaint, College complaint, human rights complaint, or a legal action." FerriScribe does not review notes for you; the review obligation is yours.
3.3 EMR integration. If you import a FerriScribe draft into an electronic medical record ("EMR") system, you are responsible for ensuring that the import is accurate and that the resulting entry complies with your EMR vendor's requirements, any applicable record-keeping rules (including retention periods under the CPSBC and any applicable provincial regime), and your practice's privacy policy.
3.4 Facility authorization. If you are employed by or practising in a hospital, clinic, or other facility where you are not the custodian of patient information (as that term is used in BC's Personal Information Protection Act, SBC 2003, c 63 ("PIPA")), you must obtain facility or institutional authorisation before using FerriScribe.
3.5 Compliance with law and College guidance. You agree to use FerriScribe in compliance with applicable privacy legislation (including PIPA for custodians in British Columbia, and PIPEDA where federal law applies), the CPSBC Ethical Principles for AI in Medicine, and any guidance from your College or regulatory body. These Terms do not relieve you of any personal legal or professional obligation you have as a physician.
4.1 Local-first architecture. FerriScribe is designed so that patient-identifiable audio, transcripts, and generated notes remain on your device by default. The project does not collect, store, or process your patients' personal health information on remote servers, and the local-only operating mode involves no network transmission of patient data at all.
When you enable an optional cloud model, data may be transmitted to a third-party provider. In that scenario: (a) the project does not receive, store, or use your patients' personal health information for model training, product improvement, marketing, or any other secondary purpose; (b) the project does not share your patients' personal health information with any party. Any data flow between your device and a cloud provider is initiated by you and governed by that provider's own terms and privacy policy.
4.2 No central data collection. The project does not operate a backend service that receives patient data. Crash reports, telemetry, and usage analytics (if any) are opt-in and contain no patient-identifiable information.
4.3 Breach notification. Because patient data resides on your device (and not on project-operated servers), breach notification obligations under PIPA, PIPEDA, or other privacy legislation generally fall on you as custodian. If the project becomes aware of a vulnerability in FerriScribe that could reasonably lead to a privacy breach, the project will endeavour to disclose it through the project's public channels (e.g., GitHub repository, project website) in a timely manner.
4.4 Data retention and deletion.
(a) Raw audio recordings, transcripts, and draft notes reside on your device. It is your responsibility (not the project's) to manage retention and deletion of those files in accordance with your practice's policies, the CPSBC record-keeping guidance, and any applicable College or health authority policy.
(b) The CMPA notes that the Collège des médecins du Québec suggests raw recordings and verbatim transcripts of encounters qualify as "draft aids" that should be destroyed after the chart entry has been finalised. Other provinces' Colleges are generally silent on this point. We recommend you follow the guidance of your own College and any applicable health authority. FerriScribe does not automatically delete your local files; you control that process.
(c) If you use an optional cloud model and a third-party provider retains data on its servers, the retention period is governed by that provider's own terms.
4.5 Privacy impact assessments. Some jurisdictions (notably Québec and Alberta) require or encourage a Privacy Impact Assessment (PIA) before implementing an AI scribe. Because FerriScribe's default mode processes all data locally, the PIA analysis may differ from cloud-based scribe services. You are responsible for determining whether a PIA is required in your jurisdiction and, if so, completing one before use.
5.1 FerriScribe uses artificial intelligence ("AI") to produce transcriptions and draft clinical notes. AI systems may:
(a) "hallucinate" — produce text that sounds plausible but is factually incorrect;
(b) misinterpret audio, especially in the presence of strong accents, overlapping speech, background noise, or technical audio issues;
(c) introduce bias — reproduce patterns present in the training data that may not be appropriate for a particular patient or clinical context; and
(d) omit information — fail to capture details from the encounter.
5.2 FerriScribe is not a medical device under the Canadian Medical Devices Regulations (SOR/98-282). It is a drafting aid. The project does not represent or warrant that any output from FerriScribe is clinically accurate, complete, or appropriate for any particular patient. The output must be reviewed and approved by a qualified physician before use in any clinical context.
This section follows the CMPA's guidance (Dec 2025 revision). The CMPA specifically warns against "blanket clauses that shift all risk to the physician." Under these Terms, you retain full ownership of clinical judgment, and the project makes no claim to it.
6.1 You are responsible for:
(a) obtaining and documenting patient consent;
(b) reviewing, editing, and approving every AI-generated note or draft before it enters a patient record;
(c) the clinical accuracy, completeness, and appropriateness of every medical note, referral letter, or other clinical document that enters a patient's record, regardless of whether FerriScribe contributed to its drafting;
(d) compliance with your College's guidance, privacy legislation (PIPA, PIPEDA, or any applicable provincial regime), and any facility or institutional policy;
(e) EMR import accuracy and record-keeping compliance, including retention periods; and
(f) any loss or damage that results from your failure to perform the obligations in this Section 6.1.
6.2 The project does not and cannot accept responsibility for clinical outcomes. FerriScribe is a drafting tool operated by you on your own device. The project does not review, approve, or guarantee the accuracy of any note you produce with the software.
7.1 FerriScribe is open source software made available freely under the terms of its open source licence (see Section 9). Consistent with open source norms, the software is provided "AS IS" and "AS AVAILABLE," without warranty of any kind, express or implied.
7.2 To the maximum extent permitted by applicable law, the project and its contributors disclaim all warranties, including (but not limited to) implied warranties of merchantability, fitness for a particular purpose, non-infringement, and any warranty that the software will be error-free, uninterrupted, or secure.
7.3 To the maximum extent permitted by applicable law, in no event shall the project or its contributors be liable for any claim, damages, or other liability, whether in contract, tort (including negligence), breach of statutory duty, or otherwise, arising from or in connection with your use of FerriScribe. This includes, without limitation, any direct, indirect, incidental, special, consequential, or punitive damages, including (but not limited to) loss of profits, loss of data, loss of goodwill, business interruption, personal injury, or death.
7.4 Nothing in this Section 7 excludes or limits liability for:
(a) fraud or fraudulent misrepresentation by the project; or
(b) any liability that cannot, as a matter of British Columbia law, be excluded or limited.
8.1 You agree to indemnify and hold harmless the project and its contributors from any claim, demand, loss, damage, cost, or expense (including reasonable legal fees) arising out of or related to:
(a) your use of FerriScribe, including any clinical note or document you produce with FerriScribe and place in a patient record;
(b) your failure to obtain or document patient consent as required by Section 3.1;
(c) your failure to review and approve AI-generated content as required by Section 3.2;
(d) your breach of these Terms or of any applicable law, College rule, or facility policy; and
(e) your gross negligence or wilful misconduct in connection with FerriScribe.
9.1 FerriScribe and its source code are made available under an open source licence on GitHub (cortexuvula/ferriscribe). The open source licence governs your right to copy, modify, and redistribute the source code.
9.2 These Terms of Service govern your use of the software as a tool in clinical practice and are separate from, and additional to, the open source licence. If the terms of the open source licence and these Terms conflict, the open source licence governs your rights to the source code; these Terms govern your use of FerriScribe in connection with patient encounters and clinical documentation.
9.3 You retain all right, title, and interest in and to the patient data (audio recordings, transcripts, draft notes, and any edited or approved final notes) that you generate using FerriScribe. The project claims no ownership in your patient data.
10.1 These Terms take effect on the date you first install or use FerriScribe and continue until terminated.
10.2 You may terminate these Terms at any time by ceasing to use FerriScribe.
10.3 On termination, your obligations under Sections 3 (Your Obligations), 6 (Your Responsibility for Clinical Accuracy), 8 (Indemnification), and 12 (Governing Law) survive termination to the extent necessary to give them effect.
11.1 These Terms are governed by and construed in accordance with the laws of the Province of British Columbia and the applicable laws of Canada (federal) that apply within British Columbia.
11.2 The courts of British Columbia have exclusive jurisdiction to hear and determine any dispute arising out of or in connection with these Terms, and you irrevocably submit to that jurisdiction.
11.3 The Limitations Act, RSBC 2012, c 165 (the "Limitations Act") applies. Subject to any longer period that cannot be contracted out of, any action or proceeding arising out of these Terms or the use of FerriScribe must be commenced within the basic limitation period set out in s. 6 of the Limitations Act (two years from the date the claim was discovered) or any extended period that may apply.
12.1 These Terms are grounded in British Columbia law (PIPA, CPSBC standards, the Limitations Act, and BC common law). FerriScribe may be used by physicians in other Canadian provinces or territories. Where a physician's province has different privacy legislation (for example, PIPEDA in a non-PIPA province, or Quebec's Act respecting the protection of personal information in the private sector), different College guidance, or different record-keeping rules, that physician is responsible for complying with the applicable provincial requirements in addition to these Terms. These Terms do not purport to override or displace any more protective provincial obligation that applies to you.
13.1 Entire agreement. These Terms constitute the entire agreement between you and the FerriScribe project relating to your use of FerriScribe and supersede any prior understandings or agreements on that subject.
13.2 Amendment. These Terms may be amended from time to time. If a material amendment is made, the project will endeavour to notify users (for example, through the project's GitHub repository or website). Your continued use of FerriScribe after the amendment date means you accept the amended Terms.
13.3 Severability. If any provision of these Terms is found to be invalid or unenforceable by a court of competent jurisdiction, the remaining provisions remain in full force and effect.
13.4 Waiver. No failure or delay in exercising any right or remedy under these Terms operates as a waiver of that right or remedy.
13.5 Third-party tools. FerriScribe may incorporate or integrate with third-party software, libraries, or cloud services. Your use of those third-party components is subject to their own terms and privacy policies. The project is not a party to any agreement between you and a third-party component provider.
13.6 No partnership or agency. Your use of FerriScribe does not create a partnership, joint venture, employment, or agency relationship between you and the project or any contributor.
Questions about these Terms may be directed to the FerriScribe project through its public channels: