What Is a Good Faith Exam? A Complete Guide for Med Spa and Wellness Clinic Owners

If you operate a medical spa, IV hydration clinic, weight loss center, or any other wellness practice that offers prescription-based treatments, you have almost certainly encountered the term "good faith exam" — or GFE. But what exactly is it, who needs to perform it, and what happens if you skip it? This guide answers those questions clearly, so you can keep your practice compliant and your clients protected.

Good Faith Exam Definition

A good faith exam (GFE) is a medical evaluation conducted by a licensed healthcare provider before a patient receives a treatment or prescription. The purpose is to assess whether the patient is an appropriate candidate for the proposed treatment — reviewing their health history, current medications, contraindications, and any clinical factors that could affect safety or outcomes.

In the context of medical aesthetics and wellness, the GFE is the clinical gatekeeping step that legally and ethically precedes treatments like:

• Botulinum toxin injections (Botox, Dysport, Xeomin)
• Dermal fillers
• IV vitamin therapy and hydration infusions
• GLP-1 weight loss medications (semaglutide, tirzepatide)
• Hormone replacement therapy (HRT/TRT)
• Peptide therapy protocols
• Prescription topicals and oral medications

Why Is the Good Faith Exam Required?

The good faith exam requirement exists because the treatments offered at med spas and wellness clinics are medical procedures — even when they feel routine or cosmetic. State medical boards, telemedicine regulations, and prescribing laws require that a licensed provider establish a valid patient-provider relationship before prescribing or overseeing treatment.

Without a properly conducted GFE, your clinic could face:

• Regulatory violations and license sanctions
• Pharmacy and compounding partner terminations
• Malpractice exposure for both providers and clinic owners
• Insurance claim denials and legal liability in the event of an adverse event

Beyond compliance, the GFE protects your clients. Identifying contraindications before treatment is how your clinic demonstrates clinical responsibility — and it builds the trust that keeps clients coming back.

Who Can Perform a Good Faith Exam?

This varies by state, but in most jurisdictions, a good faith exam must be conducted by a licensed healthcare provider authorized to prescribe within their scope of practice. That typically includes:

• Medical Doctors (MD) and Doctors of Osteopathic Medicine (DO)
• Nurse Practitioners (NP) — in states where NPs have full or collaborative prescriptive authority
• Physician Assistants (PA) — under physician supervision as required by state law

Registered nurses, medical assistants, aestheticians, and non-clinical staff cannot legally conduct a good faith exam, even if they have years of experience in a clinical setting. If your clinic is currently having non-prescribers perform intake evaluations that function as GFEs, this is a significant compliance risk that needs to be addressed immediately.

Can a Good Faith Exam Be Done via Telehealth?

Yes — and this is where telehealth has dramatically expanded access to compliant GFE services for wellness clinics. In most states, a good faith exam can be conducted via synchronous telehealth (live video) as long as it meets the minimum standard of establishing a valid patient-provider relationship.

Telehealth GFEs allow clinics to:

• Scale across multiple locations without requiring an on-site physician
• Provide same-day or next-day exam availability for clients
• Document the encounter in a compliant electronic health record (EHR)
• Reduce overhead compared to maintaining a full-time on-site physician

Important caveat: some states have specific requirements about what constitutes a valid telehealth GFE — including whether asynchronous evaluations (questionnaires reviewed without a live visit) are acceptable. State-specific rules vary, and your clinic should work with a compliance-savvy MSO or legal advisor to confirm what is permitted in each state you operate.

What Does a Good Faith Exam Include?

A compliant good faith exam is not a rubber stamp. It is a clinical evaluation that should include:

Health history review. Current and past medical conditions, surgical history, allergies, and medications.

Contraindication screening. Conditions that may prevent treatment or require modification (pregnancy, autoimmune disorders, certain medications).

Treatment-specific assessment. Evaluation of the client's suitability for the specific treatment being requested.

Informed consent discussion. The client understands the procedure, risks, and alternatives.

Documentation. The encounter is recorded in the client's medical record with date, provider identity, findings, and treatment approval or deferral.

Good Faith Exams by Service Type

IV Hydration and Vitamin Therapy

IV therapy clinics are among the most frequently scrutinized for GFE compliance. Because IV infusions carry risks related to ingredients (high-dose vitamins, minerals, NAD+, glutathione) and administration method, a GFE establishing cardiac, renal, and allergy history is essential before the first infusion. Many states require this to occur before each new formula or at least annually for returning clients.

GLP-1 Weight Loss Programs

Semaglutide and tirzepatide prescriptions require a thorough GFE covering BMI, metabolic history, personal and family history of thyroid cancer, pancreatitis risk, GI conditions, and current medications. Given the regulatory pressure on compounded GLP-1 medications in 2025 and 2026, robust GFE documentation is more important than ever to demonstrate medical necessity.

Injectables and Aesthetic Treatments

Neuromodulator and filler treatments require evaluation of neuromuscular conditions, bleeding disorders, known allergies (including lidocaine sensitivity for some fillers), and current use of anticoagulants. The GFE also establishes treatment goals and identifies anatomical considerations that inform protocol selection.

How Wellness MD Group Supports GFE Compliance

Wellness MD Group provides telehealth GFE infrastructure for med spas and wellness clinics nationwide. Our physician network conducts good faith exams at $21.99 per exam, with volume bundles available for high-frequency practices. Every GFE is documented in a compliant EHR system, and our medical directors provide the clinical oversight structure that makes the process defensible to regulators and insurers alike.

Whether you need GFE support for a single location or a multi-clinic network, our team can build a scalable, compliant process around your service menu and your state's requirements. Contact us to get started.

Bottom Line: The GFE Is Not Optional

The good faith exam is a foundational compliance requirement for any clinic offering prescription treatments or medically supervised services. It protects your clients clinically, protects your clinic legally, and establishes the physician-patient relationship that is required to operate within the law.

If your GFE process is informal, inconsistently documented, or non-existent, now is the time to fix it. Contact Wellness MD Group to learn how to build a scalable GFE infrastructure that meets your state's requirements and supports your growth.