Guide · Medical oversight
What is a good faith exam?
A good faith exam is a medical evaluation by a licensed clinician before a client receives a medical-aesthetic treatment. The clinician reviews the client's health history and contraindications, decides whether the treatment is appropriate, and documents that decision.
Many states require one before a nurse or other non-prescribing staff member performs treatments such as neurotoxin or filler injections. This guide covers who can perform it, how it works by telehealth, and what it does not cover.
Updated October 29, 2026. General information, not legal advice; rules differ by state.
Why med spas need good faith exams
Injectables and many energy-based treatments are medical procedures. In most states, the staff who perform them need an order or treatment plan from a clinician with prescribing authority, and that clinician must first evaluate the client. The good faith exam is that evaluation.
It protects the client, by catching contraindications such as pregnancy, certain medications or a history of reactions, and it protects the business, by putting a documented clinical decision behind every treatment.
Who can perform one
It depends on the state. Physicians can perform good faith exams everywhere. In many states nurse practitioners can as well, and in some, physician assistants can, within their scope of practice and any supervision rules that apply to them.
Registered nurses and aestheticians generally cannot perform the exam itself, though they may carry out the treatment the clinician orders. Check your state's medical and nursing board rules for the exact line.
In person or by telehealth
Many states allow good faith exams by telehealth, which is why remote exam services exist. The details differ: some states require a live audio-video visit, and a questionnaire reviewed later is often not enough on its own.
Whichever route you use, the clinician must be licensed in the state where the client is treated, and the exam must be documented in the client's record.
What happens during the exam
The clinician reviews the client's medical history, current medications and supplements, allergies, pregnancy or breastfeeding status, previous treatments and reactions, and what the client hopes to achieve. Depending on the treatment, they may look at the area to be treated.
They then decide whether the treatment is appropriate, set any limits on it, and document the outcome. A good exam can end in "no". A process where every client is cleared is a warning sign, not a feature.
How long a good faith exam lasts
There is no single national rule. Many practices treat an exam as covering a treatment plan for a defined period, and repeat it when the client's health history changes or they start a new kind of treatment. Your state's rules and your clinician's judgment set the actual interval.
Good faith exam vs good faith estimate
The names are similar, but they are unrelated. A good faith estimate is a cost estimate that federal law requires providers to give uninsured or self-pay patients before care. A good faith exam is the clinical evaluation described here. If you are searching for one, results for the other will not help.
Common questions
- Is a good faith exam required for Botox?
- In many states, yes, when someone other than a prescribing clinician administers it: a licensed clinician must evaluate the client and order the treatment first. Requirements differ by state, so confirm with your state board.
- Can a nurse do a good faith exam?
- A registered nurse generally cannot perform the exam itself. In many states a nurse practitioner can, within their scope of practice. The exact rule depends on the state.
- Is there a good faith exam form or template?
- Clinicians use forms to document the exam, and many practices standardize them. A template is only a record, though: the exam is the clinician's evaluation, and filling in a form without one does not meet the requirement.
- Does a good faith exam replace a medical director?
- No. It covers the evaluation before treatment. Many states also expect physician oversight of protocols, delegation, supervision and complications, which a good faith exam on its own does not provide.
Good faith exams from KiteMD
KiteMD is piloting telehealth good faith exams for med spas: licensed clinicians, a flat fee per exam, and clinicians paid the same whatever the outcome.