What it is
A Good Faith Exam (sometimes called a pre-treatment evaluation) is a clinical assessment performed before a medical aesthetic treatment. Its purpose is to confirm the treatment is medically indicated, identify contraindications, and establish that the patient is an appropriate candidate. It is a clinical act, not a formality.
When it may apply
Some states require a Good Faith Exam before certain aesthetic treatments — especially those involving prescription products like neurotoxins and dermal fillers. The exam typically occurs before the first treatment and may need repeating at defined intervals, such as before a new treatment area or after a long gap.
Who may perform it
State rules determine who may perform the exam. In many states it must be a physician, NP, or PA — not delegated to an RN without specific authority. Your license and your state's delegation rules govern who conducts it and how treatment authorization flows from it.
Telehealth considerations
Some states permit telehealth-based exams for certain treatments; others require in-person assessment. Telehealth rules differ by state, treatment, and provider, and may carry extra consent and documentation requirements. Confirm whether telehealth is allowed for your treatment before relying on it.
Documentation
Document the exam like any clinical assessment: history, exam findings, assessment, treatment decision, and the provider who performed it. The record should be dated, retrievable, and linked to the treatment note. An undocumented exam may be treated as if it never happened.
State variation
Requirements vary widely. Some states mandate the exam for prescription aesthetic treatments; others are less prescriptive. Some define who must perform it; others leave it to delegation rules. Check your medical and nursing board guidance and confirm with legal counsel.
What to confirm
- Whether your state requires a Good Faith Exam for the treatments you offer.
- Who may perform it under your license and state rules.
- Whether telehealth is permitted, and with what documentation.
- When the exam must be repeated.
- How you will document and retrieve the exam record.
Treat the exam as the clinical foundation for treatment, not a checkbox.