A good faith exam is a medical evaluation that must happen before a patient receives certain treatments at a med spa, wellness clinic, or similar facility. It establishes a legitimate patient-provider relationship and confirms the patient is a safe candidate for the procedure. Think of it as the medical checkpoint between walking into a med spa and actually getting Botox, fillers, laser treatments, or IV therapy.
The concept exists because these treatments involve prescription drugs or medical devices, and providing them without a proper evaluation is considered unprofessional conduct under medical licensing laws. California, one of the first states to codify the requirement, treats prescribing or dispensing drugs without a good faith prior examination as a violation that can result in disciplinary action against the provider’s license.
What Happens During the Exam
A good faith exam isn’t a full physical. It’s a focused evaluation tailored to the specific treatment you’re seeking. The provider reviews your medical history, current medications, allergies, and any conditions that could make the procedure risky. They assess the treatment area, discuss your goals, and determine whether the procedure is medically appropriate for you.
Rather than following a rigid checklist defined by statute, the exam is treated as a standard-of-care issue. That means what counts as “good faith” is judged based on the specific facts of each case. A provider evaluating someone for injectable fillers will focus on different factors than one clearing a patient for IV vitamin therapy. The common thread is that the provider must genuinely assess the patient’s suitability, not just rubber-stamp a form.
Who Can Perform One
Only certain licensed professionals can conduct a good faith exam: physicians (MDs and DOs), physician assistants, and advanced practice nurses such as nurse practitioners. When a PA or nurse practitioner performs the exam, they typically need formal delegation from a supervising or collaborating physician authorizing them to do so.
Registered nurses and licensed practical nurses cannot perform good faith exams independently. If an RN administers neurotoxins or dermal fillers without a documented prior evaluation by an authorized provider, regulators may treat this as operating outside lawful boundaries. Standing orders alone, where a physician writes a blanket protocol without evaluating individual patients, are not sufficient in many jurisdictions. Someone qualified must actually assess the patient before treatment is delegated.
In-Person vs. Virtual Exams
Most states now allow good faith exams to be conducted through telemedicine, but with a key restriction: the evaluation must happen over live, synchronous video. A phone call doesn’t count. Filling out a health questionnaire online doesn’t count. Text-based exchanges don’t count. The provider needs to see and interact with the patient in real time, just as they would in person.
For a virtual exam to meet compliance standards, it should use a HIPAA-compliant video platform. The provider verifies the patient’s identity and location, confirms their own licensure in that state, and documents the encounter in the patient’s medical record along with any signed consents. This has made good faith exams more accessible for patients at med spas that use remote medical directors, but the standards for the evaluation itself remain the same.
How Long a Good Faith Exam Stays Valid
A good faith exam is not a one-time event. Most states require renewal every 12 months, and there are situations that trigger a new exam sooner than that. If you add a different type of procedure to your treatment plan, a new evaluation is required. If your health status changes (new medications, a new diagnosis, new allergies), the provider should reassess you before continuing treatment.
This matters practically if you’re a regular med spa client. Even if you’ve been getting the same injections for years, your provider should be re-evaluating you at least annually to confirm you’re still a good candidate.
Why It Matters for Patients
From a patient’s perspective, the good faith exam is a safety mechanism. It’s the step that separates a legitimate medical aesthetic practice from one cutting corners. If a med spa lets you walk in and receive injectable treatments without any provider ever reviewing your history or examining you, that’s a red flag for how the rest of the operation is run.
The consequences for facilities that skip this step are serious. Fines can range from $5,000 to $50,000 per incident. Providers who delegate exams improperly or allow unqualified staff to perform them risk probation, suspension, or revocation of their medical license. Both the individual provider and the med spa owner can be held accountable. If a patient has an adverse reaction and no documented exam exists, the practice faces direct liability, and missing documentation is one of the most common triggers for board investigations.
What This Means If You’re Visiting a Med Spa
If you’re scheduling a cosmetic or wellness procedure for the first time at a new practice, expect some version of this exam before treatment begins. You’ll review your medical history, discuss what you want done, and a qualified provider will confirm you’re a safe candidate. This might happen in person or over video, and it might be with the same person who performs your treatment or a separate supervising provider.
A good sign is a practice that takes this step seriously, asks thorough questions, and documents everything. A bad sign is one that treats it as an inconvenient formality or skips it entirely. The exam exists to protect you, and how a practice handles it tells you a lot about how they handle patient safety overall.