The Good Faith Exam
A Good Faith Exam (GFE) is the medical evaluation a patient must receive before a med spa treatment — a review of their history, an appropriate exam, and a treatment plan — so that injectables or other medical services are properly ordered for that specific person. It has to be performed by a qualified prescriber: a physician, or a nurse practitioner or physician assistant where the state allows — not by the registered nurse who often administers the treatment. In many states the GFE can be done by synchronous telehealth, which is why per-patient telehealth-GFE services exist. It’s a required step before treatment, and the specifics vary by state — we map yours inside.
The free 7-minute assessment maps the structure, the requirements, and the exact next step to your credential and your state. No card. Built by Faisal Darwiche, NP — 27 years, three practices.
A Good Faith Exam is the patient evaluation that has to happen before a medical aesthetic treatment. The provider reviews the patient’s history, performs an appropriate examination, confirms the treatment is suitable, and orders it. It’s what makes a treatment properly ordered for that specific patient, rather than handed out without a medical decision.
Think of it as the medical front door of every treatment. Before any neurotoxin, filler, or other medical service, a qualified prescriber has to evaluate the patient and decide the treatment is appropriate — then issue the order the injector works under. It’s a standard, expected part of running a compliant practice, not an optional formality.
The Good Faith Exam must be performed by a prescriber — someone licensed to diagnose and order treatment. That’s a physician, or a nurse practitioner or physician assistant where the state permits. It is not performed by the registered nurse who often injects; an RN may collect information and assist, but can’t perform the GFE or order treatment.
This is the distinction people most often get wrong. The RN who administers the neurotoxin or filler is working under an order — she doesn’t create it. The exam and the order come from a prescriber: the medical director, a delegated NP or PA where allowed, or a telehealth-GFE service. That separation between who orders and who injects is the backbone of a compliant med spa.
In many states, yes — the Good Faith Exam can be performed by synchronous, real-time audiovisual telehealth, with no prior in-person visit required. That’s exactly why per-patient telehealth-GFE services exist: they connect a qualified prescriber to evaluate and order remotely. The rules differ by state, so confirm telehealth is permitted where you practice.
For many new owners — especially an RN who needs a prescriber for the exam and the order — a telehealth-GFE service is how the clinical gate gets covered per patient without a physician physically on site for every visit. Whether synchronous telehealth satisfies the GFE, and what documentation it requires, is state-specific, so it’s one of the first things to confirm for your state.
Because medical aesthetic treatments are medicine, not retail. The Good Faith Exam is the medical decision that a specific treatment is appropriate and safe for a specific patient, and it’s what authorizes the order the injector works under. Skipping it means treating without a valid order — the compliance failure regulators act on most.
It also protects the patient and the practice. The exam screens for contraindications, sets the right treatment plan, and creates the record that the care was properly ordered. A med spa that treats without a GFE isn’t just cutting a corner — it’s delivering a medical service without the medical decision behind it.
Yes. The core idea is national — a prescriber must evaluate and order before treatment — but the details vary: who exactly may perform it, whether telehealth counts, and how it must be documented. An NP may perform the GFE in some states and not others. That’s why we map your state’s rule inside.
The principle holds everywhere; the specifics are where states diverge. Some require a physician for the exam in the cosmetic context; others let an NP or PA perform it; telehealth is accepted in many but not all. Rather than guess from a national rule that might not match your state, the assessment maps your state’s GFE requirement to your credential — and your own healthcare attorney confirms the final setup.
It’s the medical evaluation a patient must receive before treatment — a review of history, an appropriate exam, and a treatment plan — so that injectables or other medical services are properly ordered for that specific patient. A qualified prescriber performs it, and it’s a required step before treatment in most states.
A prescriber licensed to diagnose and order treatment: a physician, or a nurse practitioner or physician assistant where the state allows. It can be done in person or, in many states, by synchronous telehealth. The registered nurse who administers the treatment does not perform the Good Faith Exam.
No. An RN can collect patient information and assist, and administers treatments under a valid order, but cannot perform the Good Faith Exam or order treatment — that requires a prescriber (a physician, or an NP or PA where the state allows). This is why an RN owner contracts a medical director or uses a telehealth-GFE service.
In many states, yes — by synchronous, real-time audiovisual telehealth, often with no prior in-person visit required, which is why per-patient telehealth-GFE services exist. Whether telehealth satisfies the GFE, and how it must be documented, varies by state, so confirm the rule where you practice.
In most states, yes. Neurotoxin and dermal filler are medical treatments, so a prescriber must perform a Good Faith Exam and order the treatment before an injector administers it. The specifics — who performs it and whether telehealth counts — vary by state, which we map inside the assessment.
Faisal Darwiche, NP — 27 years as a nurse practitioner and three practices opened, including one later sold. My Practice Academy is the operating system for opening and running your own aesthetic practice — the clinical work and the business, in the right order.