Depending on how you work, you can be in either template-editing or patient document-editing mode. Template-editing is the means to creating a custom patient document.
To determine if you are editing a template or a patient document
There are multiple factors to check:
If you see the Patient name, you are editing a patient document, not a template. For example:
If you do not see a patient name, you are editing a template. For example:
If you see merge fields such as <<patient.name>>, or placeholder graphics with the red "Placeholder" label, you are editing a template.
If you see a patient name and graphics without the red "Placeholder" label, you are editing a patient document.