yes you can use electronic signatures. we have been ehr since 2008, we have been picked a few times each year to send in visit notes and signatures. Out of 22 offices in our area alone, there was 3 that had all information correct, and yes we were 1 of the 3. Patients sign in on a signature pad and notes are signed electronically also by providers. either way, they are automatically date and timed stamped.