A remote good faith exam has three fixed requirements: a provider licensed in the state where the patient is physically located, a platform that meets that state’s telehealth standard, and a renewal system tied to the patient record instead of a shared calendar. A multi-location program multiplies each requirement across every site it operates. One noncompliant location is enough to trigger an audit of the entire program.

Licensure Across State Lines

A remote good faith exam is valid only if the provider holds an active license in the state where the patient is physically located, not the state where the clinic is headquartered. Reciprocity, delegation authority, and supervision requirements differ by state, so a licensing model that works in one state can fail in another. A franchise adding a second location needs to verify all three before treating a single patient there.

• California: A provider treating a California patient by telehealth needs an active California license under Business and Professions Code Section 2242, since the state does not recognize automatic reciprocity.
• Arizona: Nurse practitioners hold full practice authority, so an NP-owned program can run exams and issue treatment orders without a supervising physician, provided the NP holds an Arizona license.
• Louisiana: State nursing board guidance requires the exam to come from a physician or a nurse practitioner collaborating with one, so a Louisiana location needs a documented collaboration agreement in place before treatment.

Before adding a location, confirm the provider roster includes someone licensed there, and check whether that state requires a collaboration or supervision agreement before the first good faith exam is scheduled.

Platform Requirements

A remote good faith exam platform has four non-negotiable requirements. These requirements apply whether the exam runs in one location or fifty. State telehealth rules then layer additional technical standards on top of this baseline.

• HIPAA-compliant security: The platform must encrypt and store patient health information to HIPAA security standards, not just general data privacy practices.
• Synchronous live video: The exam has to happen over real-time, two-way video, since most states no longer accept text-only intake or automated questionnaires for higher-risk treatments.
• Sufficient video resolution: The feed needs enough clarity for the provider to conduct a visual assessment of the treatment area, not just confirm the patient’s identity.
• Secure documentation storage: Exam notes, treatment plans, and signed consent forms belong in the patient’s chart, not in a separate system disconnected from the medical record.

California and Texas both require synchronous video for higher-risk treatments. California’s medical board has moved to disallow static forms and text-only chat entirely as of 2026, while Texas still accepts a high-standard asynchronous exam if the data collected matches an in-person visit.

Florida adds a fifth layer to build into the platform. Guidance from its medical board indicates that the same provider who conducts the exam should also supervise the resulting treatment, so the platform needs to route each patient to a consistent provider record rather than to any available clinician on the roster.

Renewal Tracking at Scale

A good faith exam requires renewal on a fixed schedule with real documentation behind it. The American Med Spa Association’s guidance on good faith exam requirements points to renewal at least annually. Renewal should happen sooner if the patient starts a new treatment or reports a health change.

• Renewal frequency: Exams generally need renewal at least every 12 months, and sooner whenever a patient starts a new treatment type or reports a change in health status.
• Documented follow-up: Each renewal must include a genuine follow-up evaluation, not a reissued form, since regulators have flagged programs that skip this step.
• Per-patient delegation records: Delegation and standing orders need documentation for each individual patient, not a single blanket policy applied across the entire patient base.
• Centralized tracking: Renewal dates must be tracked in a system tied to the patient record, since manual tracking breaks down once a program operates more than a few locations.

In 2025, the Arkansas State Board of Nursing clarified that “good faith exam” does not appear in the state’s Nurse Practice Act, and flagged that exams were not always being properly conducted, particularly around follow-up. Kentucky’s nursing board guidance reinforces the same standard: delegation and standing orders must be documented per patient, not applied as a blanket policy across a growing patient base.

How Medical Director Co. Supports Multi-Location Remote Exam Programs

Medical Director Co. runs three systems for multi-location remote exam programs. For licensure, MDCo matches each location with a provider who holds an active license in that state before the first exam is scheduled. For platform compliance, MDCo builds each state’s telehealth standard directly into the exam workflow, so video format and documentation requirements are met automatically. For renewal tracking, MDCo tracks every patient’s renewal date in one centralized system tied to the patient record, not a separate calendar per location.