This study explores the impact of institutionalized formulas in the creation of electronic mental health chart records. Through a qualitative analysis of client records obtained from a private organization that provides support and rehabilitation for at-risk youth, we explore the ways that structures imposed by the electronic charts limit cohesiveness and disrupt the communication of evaluative information. This disruption, which we argue is imposed by the format of the charts themselves and is reinforced by the institutional structures at work, is pivotal because it potentially impedes effective communication and understanding between the caregivers and providers who access this information.