Blue Ink or Black Ink?

The question about what color ink to use in charts or for record-keeping is one of the more persistent myths in mental health practice. Most clinicians have heard an admonishment to use blue ink or black ink, purportedly for “legal reasons.” But no one seems to know which color is preferred. I am asked questions about ink color with a frequency that is grossly disproportionate to its importance. Let’s set the record straight:

• As of the writing of this entry, there is no statutory requirement that health records be made in any particular color. In fact, there are very few references to ink color anywhere in the entire CA Code. Black ink must be used for birth certificates, red ink must be used to mark replacement certificates of indemnity as duplicates (clinicians don’t need to know what that is), and in some matters related to insurance contracts. CA regulations also contain some references to ink color, but none relating to mental health practice or record-keeping.

As a general matter, records should be kept in ink, and they should be both legible and dark enough to be photocopied if necessary. That’s about the extent of the requirement. So where does the color preference come from? Here is the explanation:

• Some attorneys prefer that their clients use blue ink when filling out documents, executing contracts, or other things that might be the subject of litigation. The reason for this is that it makes it easier to determine the original from subsequent photocopies. However, with the increasing popularity of color copiers, this is likely to be an increasingly infrequent issue. Because of this preference on the part of some attorneys, some agencies have adopted it as an internal policy, and from there the rationale gets passed on like a game of “telephone.”

Hopefully this resolves the issue.

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