A good faith exam is a medical evaluation performed before a patient receives prescription-only aesthetic treatment. Although the term is widely used throughout the medical aesthetics industry, most state laws regulate the underlying patient evaluation instead of defining “good faith exam” as a separate legal requirement. The specific requirements vary by state, but the purpose remains the same: to establish a patient-provider relationship and determine whether treatment is medically appropriate.
Key Takeaways
- A good faith exam is a pre-treatment medical evaluation that establishes a patient-provider relationship before prescription-based aesthetic treatment. (Jump to Section)
- The evaluation generally includes a medical history review and a physical examination tailored to the planned treatment. (Jump to Section)
- Physicians, nurse practitioners, and physician assistants with prescriptive authority can perform a good faith exam, although state requirements vary. (Jump to Section)
- Good faith exams are commonly required before prescription-only treatments such as injectables, certain laser procedures, IV therapy, medical weight loss, and hormone therapy. (Jump to Section)
- Medical Director Co. helps med spas establish physician oversight that supports compliant patient evaluations. (Jump to Section)
The Real Regulatory Standard Behind the Good Faith Exam
The phrase good faith exam is commonly used throughout the medical aesthetics industry, but it is not the legal term adopted by most state medical or nursing boards. Instead, state laws and regulations often refer to concepts such as a patient-provider relationship, appropriate prior examination, or medical evaluation before treatment begins.
Although the terminology differs, the underlying expectation is largely the same. Before prescribing or administering prescription-only aesthetic treatments, an authorized healthcare provider should evaluate the patient, determine whether the treatment is appropriate, and document the clinical findings supporting that decision.
The exact requirements vary by state. For example:
- California requires an appropriate prior examination before prescribing or administering many cosmetic treatments.
- Texas requires a valid practitioner-patient relationship before delegated medical acts are performed.
- Florida regulates physician delegation and provider authority through its medical and nursing practice laws rather than using the phrase “good faith exam.”
- Arkansas, Louisiana, Kentucky, and Arizona each have their own physician delegation, telehealth, and patient evaluation requirements.
Because these requirements differ, med spas should follow the laws and regulations that apply in the state where they operate instead of relying solely on the phrase “good faith exam.”
Regardless of the terminology, the objective remains consistent: establish a documented patient evaluation before treatment begins and ensure the provider has sufficient clinical information to determine whether the patient is an appropriate candidate.
Build a Compliant Patient Evaluation Process
Qualified physician oversight with attorney-reviewed agreements.
The Two Parts of a Good Faith Exam
A good faith exam helps an authorized healthcare provider determine whether a patient is an appropriate candidate for treatment. Before prescribing or administering a prescription-only aesthetic procedure, the provider should evaluate the patient’s medical history, assess the treatment area, and identify any factors that could affect safety or treatment outcomes.
Although the specific requirements vary by state and treatment type, most good faith exams include two core components.
Medical History Review
The medical history review helps the provider identify conditions, medications, or previous treatments that could affect the patient’s suitability for the procedure.
Depending on the treatment, the review commonly includes:
- Current medications and supplements.
- Drug allergies or previous allergic reactions.
- Existing medical conditions.
- Previous cosmetic procedures.
- Pregnancy or breastfeeding status, when applicable.
- Prior complications from aesthetic treatments.
Reviewing this information helps the provider identify contraindications, adjust the treatment plan when appropriate, and determine whether additional evaluation is needed before proceeding.
Physical Examination
The physical examination focuses on the area being treated and any clinical findings relevant to the planned procedure. The extent of the examination depends on the treatment being performed.
The provider commonly evaluates:
- The condition of the treatment area.
- Skin quality, tissue health, and anatomy.
- Signs of infection, inflammation, or injury.
- Factors that could affect treatment safety or expected outcomes.
The examination should provide enough clinical information for the provider to determine whether the planned treatment is appropriate. A Botox consultation, laser procedure, IV therapy, or medical weight loss program each requires a different assessment based on the patient’s condition and the treatment being considered.
Who Can Perform a Good Faith Exam?
A good faith exam should be performed by a healthcare provider who has the legal authority to evaluate the patient and prescribe or authorize the planned treatment. The specific rules vary by state, particularly regarding delegation and prescriptive authority.
Providers commonly authorized to perform a good faith exam include:
Provider | Can Perform a Good Faith Exam? | Notes |
|---|---|---|
Physician (MD or DO) | ✔ | Can independently establish the patient-provider relationship and evaluate treatment candidacy. |
Nurse Practitioner (NP) | ✔ | Authority depends on state law, scope of practice, and any required physician collaboration. |
Physician Assistant (PA) | ✔ | Authority depends on state law and physician delegation requirements. |
Registered Nurse (RN) | ✘ | Cannot independently perform a good faith exam because RNs do not have independent prescriptive authority. |
Esthetician | ✘ | Cannot perform a medical evaluation or authorize prescription-only treatments. |
Even when an RN or esthetician performs the treatment, the required medical evaluation should already have been completed by an authorized provider before prescription-only services begin.
When Is a Good Faith Exam Required?
A good faith exam is generally required before treatments involving prescription medications or prescription medical devices. The evaluation helps confirm that the patient is an appropriate candidate and establishes the clinical basis for treatment.
Examples commonly include:
Injectable Treatments
Injectable treatments commonly involve prescription medications that require an authorized provider to evaluate the patient before treatment. The good faith exam helps confirm that the patient is an appropriate candidate, identifies any contraindications, and establishes the patient-provider relationship before the medication is administered.
Examples include:
- Botox® and other botulinum toxin products
- Dermal fillers
- Prescription injectable medications
Energy-Based Procedures
Some laser and energy-based procedures also require a good faith exam because they involve prescription medical devices or physician-delegated medical services. The exact requirements vary by state, making it important to confirm who can perform the evaluation and when it must occur.
Examples include:
- Certain laser treatments
- Intense pulsed light (IPL) procedures
- Radiofrequency treatments when regulated as medical procedures
Medical Wellness Services
Medical wellness treatments often begin with a provider evaluation to determine whether the therapy is clinically appropriate and safe for the patient. The scope of the evaluation depends on the treatment being provided and the laws of the state where the practice operates.
Examples include:
- IV therapy.
- Medical weight loss programs.
- Hormone replacement therapy.
Although these treatments commonly require a good faith exam, the specific rules differ by state. State law determines who can perform the evaluation, whether telehealth is permitted, and when repeat examinations are required. Reviewing your state’s requirements before offering prescription-based aesthetic treatments helps support ongoing compliance.
How Medical Director Co. Makes Sure Every Exam Holds Up
A compliant good faith exam begins with qualified physician oversight and documentation that reflects how the practice operates. Medical Director Co. helps med spas establish those physician relationships while supporting state-specific compliance requirements.
Every placement includes:
- Qualified physician matching: Physicians selected based on your state’s physician oversight requirements and the services your practice provides.
- Attorney-reviewed agreements: Documentation supporting physician oversight, delegation, and collaborative responsibilities.
- State-specific compliance support: Guidance tailored to your state’s physician delegation and supervision requirements.
- Ongoing physician oversight: Continued support as your practice adds providers, expands services, or updates clinical protocols.
Medical Director Co. helps practices establish physician oversight that supports compliant patient evaluations before treatment begins.
Establish Compliant Physician Oversight
Qualified physician matching with attorney-reviewed agreements.
Frequently Asked Questions
Is a good faith exam a legal requirement?
The term “good faith exam” is not specifically defined in most state laws. But the underlying medical evaluation is generally required before prescription-only aesthetic treatments. States enforce this requirement through laws governing patient-provider relationships, physician delegation, prescribing authority, or standards of care.
Who can perform a good faith exam?
A physician, nurse practitioner, or physician assistant with the authority to evaluate patients and prescribe or authorize treatment can generally perform a good faith exam. The exact requirements vary by state. Registered nurses and estheticians cannot independently perform the examination.
Does every med spa treatment require one?
Not every treatment requires a good faith exam. The requirement generally applies to treatments involving prescription medications or prescription medical devices, including injectables, many laser procedures, IV therapy, medical weight loss, and hormone therapy. State laws determine when the evaluation is required.
Is a good faith exam the same as informed consent?
A good faith exam determines whether a patient is an appropriate candidate for treatment. Informed consent is a separate process that explains the procedure, expected outcomes, potential risks, alternatives, and allows the patient to decide whether to proceed.
Can a good faith exam be done online?
Many states allow telehealth good faith exams when conducted through a live, synchronous video consultation by an authorized provider. Other states require an in-person evaluation or impose additional conditions. Telehealth requirements should always be confirmed under the laws of the state where the practice operates.
Building Compliance Starts With the Right Evaluation
A good faith exam establishes the medical foundation for prescription-only aesthetic treatment. Although states use different terminology and apply different requirements, the underlying expectation is consistent: patients should receive an appropriate medical evaluation before treatment begins. Establishing physician oversight and following your state’s requirements helps support safe patient care and compliant med spa operations.
Build Your Med Spa on a Strong Compliance Foundation
Qualified physician oversight backed by ongoing compliance support.
