The Complete Guide to Good Faith Exams (GFEs)

A Good Faith Exam (GFE) is a mandatory, procedure-specific medical evaluation undertaken by a licensed provider that assesses a patient’s medical history, current prescriptions, allergies, prior aesthetic procedures and health conditions to determine if an aesthetic treatment is safe and appropriate.

Unlike a general physical, the GFE focuses exclusively on the risk factors related to the planned treatment, must be documented, and is often required before proceeding with non-surgical services. Many states mandate it for every new patient or whenever a new treatment type is introduced.

To learn more, visit What is a Good Faith Exam?

A Good Faith Exam is a mandatory legal requirement for non-surgical aesthetic treatments at med-spas, mandated in every state because even seemingly “routine” procedures (e.g., injectables, lasers, peels) involve medical risks and must be preceded by the assessment of a licensed provider.

Beyond compliance, the exam serves critical roles: safeguarding patient safety by uncovering hidden contraindications (such as medications, medical history, or autoimmune conditions) and protecting the practice by creating documented proof of professional oversight- thus enhancing trust with patients and resilience in an era of increasing regulatory scrutiny.

To learn more, visit Why is a Good Faith Exam required in med spas?

A Good Faith Exam (GFE) is purpose-built to determine whether a patient is medically safe to proceed with a specific aesthetic or wellness procedure such as injectables, lasers, or peels. It is focused, typically shorter (10–30 minutes), and centers on treatment-specific risks such as recent medications, blood clotting issues, skin sensitivity or contraindicated therapies.

In contrast, a regular medical exam (like an annual physical) takes a broad, holistic look at overall health, disease prevention, and wellness- covering labs, multiple body systems and lifestyle factors rather than zeroing in on a single elective procedure.

To learn more, visit How is a GFE different from a regular medical exam?

A Good Faith Exam (GFE) is required for every new patient seeking a regulated aesthetic procedure regardless of how minor it might seem or whether the patient has been treated before.

Additionally, the exam must also be redone when a patient is starting a new treatment type, when there’s been a significant change in their health (such as new medications or diagnoses), or typically on an annual basis for returning patients.

To learn more, visit Is a GFE required for every patient?

Most good‐faith exams take approximately 4 to 15 minutes, with simpler cases (for example, healthy patients seeking basic injectables) completing closer to the 4-minute end, and more complex cases (patients with multiple medications, diagnoses, or several treatment requests) taking toward 15 minutes.

The actual duration depends on several factors: the patient’s health history, number and type of treatments requested, the volume of patient questions, and whether the exam is virtual or in-person.

To learn more, visit How long does a GFE take?

A Good Faith Exam (GFE) is a medical evaluation that must be conducted by a licensed medical provider who has the authority to assess patient safety and appropriateness of treatment. That means roles like physicians (MD/DO) are universally eligible; nurse practitioners (NPs) and physician assistants (PAs) often are eligible depending on the state and on supervision/delegation agreements.

In contrast, unlicensed staff, including aestheticians, medical assistants, and other non-provider personnel, cannot perform GFEs. While registered nurses (RNs) may assist with intake or support, they cannot independently perform or document a GFE. Delegation must be documented, and all state laws must be followed.

To learn more, visit Who can perform a Good Faith Exam?

The average wait time for a patient to connect with Spakinect as a provider is just 1 to 2 minutes, with the typical case clocking in at “just under one minute.”

This rapid connection allows med-spa teams to keep schedules on track, reduce delays, and integrate compliant Good Faith Exams into the workflow without creating a bottleneck.

To learn more, visit What is the average wait time to connect with a provider?

The fee for a Good Faith Exam (GFE) fluctuates based on state laws, whether it’s conducted in-person or virtually, and whether the practice handles it internally or outsources it.

Rather than simply being an added cost per patient, it should be viewed as an investment in compliance, patient safety, and operational efficiency- particularly when outsourced, the exam can streamline workflow, reduce administrative burden, and enable your team to focus on revenue-generating activities.

To learn more, visit How much does a GFE cost?

Yes, you do need a new Good Faith Exam (GFE) even if you’ve had the same treatment before. The rationale is that previous treatments don’t automatically account for changes in your health status such as new medications, allergies, or diagnoses that could alter your candidacy or increase treatment risks.

Every patient must be evaluated by a licensed provider under state regulations, and that past experience with a treatment does not exempt someone from that exam requirement.

To learn more, visit Do I need a GFE if I’ve had treatments before?

A Good Faith Exam (GFE) may be conducted either in person or via a secure telehealth platform, depending on the law in your state. What matters legally is that a licensed provider performs the exam and that the exam is properly documented.

Virtual GFEs are increasingly common in med-spa settings because they offer greater convenience, efficiency, and patient comfort, and they can still satisfy the same compliance and documentation standards as an in-person visit. However, note that some states may require an initial in-person exam or restrict virtual options for certain procedures, so checking your specific state rules is essential.

To learn more, visit Is the GFE done in person or virtually?

In most cases, patients can receive treatment on the same day as their Good Faith Exam (GFE). Oonce a licensed provider completes the exam, the necessary documentation is in place, and no red flags are identified, treatment may proceed that same day.

However, same-day treatment is not automatic. It may be delayed if state law imposes a waiting period, if the provider requests additional information, or if the exam reveals new medications, health disclosures or other contraindications that require follow-up before treatment can safely begin.

To learn more, visit Can patients get treatment the same day as their GFE?

A new Good Faith Exam (GFE) is required whenever a patient requests a treatment they have not previously had or when moving into a different treatment modality- for example switching from injectables like Botox to microneedling or laser work.

While it may feel like added friction operationally, performing treatment-specific exams is critical for patient safety and compliance, because each procedure carries its own risks and eligibility criteria.

To learn more, visit Is a GFE required before every new type of treatment?

A good-faith exam (GFE) is typically required to be renewed at least annually in most states. Additionally, a new exam is needed whenever a patient introduces a new treatment type or their health status changes significantly, as these trigger reassessment of suitability and compliance.

To learn more, visit How often does a GFE need to be renewed?

Only licensed medical professionals working within their scope of practice can perform a Good Faith Exam. Depending on the state, this may include physicians (MDs or DOs), nurse practitioners (NPs), or physician assistants (PAs).

Some states permit registered nurses (RNs) to assist under supervision; however, RNs typically cannot independently diagnose or prescribe treatments. Med spas must always confirm that their chosen provider meets state-specific licensing and delegation standards.

State laws around Good Faith Exams (GFEs) vary widely, with differences in telehealth allowances, who may perform the exam, and documentation requirements. Because requirements aren’t uniform, compliance processes must often be adapted by state.

• Some states allow fully virtual GFEs
• Others require live, synchronous exams
• Rules differ on who may perform the GFE (MD, NP, PA, etc.)

To learn more, visit Do GFE laws differ by state?

Failure to perform a Good Faith Exam before treatment is considered a serious compliance violation. Consequences can include disciplinary action, fines, loss of licensure, or even closure of the medical spa. Additionally, insurers may deny claims if proper documentation of a GFE is missing.

No, a patient cannot refuse a Good Faith Exam (GFE). The exam is a legal requirement before any aesthetic treatment involving a prescription drug, device, or regulated procedure and a waiver cannot substitute for it.

Skipping the GFE, even at the patient’s request, exposes both the provider and the med-spa to serious liability: state boards may investigate, insurance might deny coverage, and licensure or delegation privileges could be jeopardized.

To learn more, visit Can a patient refuse a GFE?

Even if you outsource your Good Faith Exams (GFEs) to a third-party provider, you still need a licensed medical director. Outsourcing the exams does not replace the medical director’s clinical oversight and regulatory responsibility.

The medical director remains the clinical authority: defining protocols, approving treatments, supervising or delegating providers, and ensuring your med-spa remains compliant with state laws. Outsourced providers handle exam execution and documentation, but the medical director retains overall accountability.

To learn more, visit If I outsource GFEs, do I still need a medical director?

Each state sets distinct rules for med-spa compliance, covering ownership, delegation, supervision, and the required “good faith exam” before treatments. These laws determine who may perform the exam, how and when it can be done (in-person vs virtual), who may delegate treatments, and how long records must be retained.

Failing to adhere can trigger serious consequences: fines (often $5K–$50K per violation), suspended licenses, investigations that halt operations, and damage to your practice’s reputation. Because compliance requirements vary so much by state, relying on a one-size-fits-all model is risky.

To learn more, visit What are the compliance laws in my state?

Some states permit “asynchronous” (store-and-forward) good-faith exams, where a patient submits photos, forms, or questionnaires for later review. Other states mandate “synchronous” exams, meaning a real-time video (or audio-video) call between provider and patient.

However, the majority of state medical boards still favor synchronous exams for med-spa procedures: live interaction lets providers ask follow-up questions, assess physical cues, confirm understanding, and establish a patient-provider relationship- all of which support safety and legal compliance.

Because rules vary widely state to state and change over time, you must check your state’s telehealth / med-spa regulations before offering asynchronous GFEs.

To learn more, visit Can I Do Async, or Does My State Require Sync?

Most med-spa treatments that involve prescription drugs or devices, or any procedure that penetrates the skin or requires medical judgment- injectables (like Botox, fillers), laser or energy-based treatments, microneedling, IV therapy, hormone or weight-management injections, and medium-to-deep chemical peels all require a Good Faith Exam (GFE) before treatment.

Basic spa services that do not use medical-grade products, do not involve skin penetration or physiologic alteration (like cleansing, light exfoliation, massage, topical skincare) generally do not require a GFE.

To learn more, visit Are GFEs required for all services, or only certain ones?

Documentation to keep on file

Med spas must keep detailed records of every GFE, including patient history, provider notes, and informed consent documentation.

To learn more, visit What Documentation Needs to Be Kept to Prove a Good Faith Exam Was Completed

Record retention period

Record retention laws vary, but most states recommend retaining GFE documentation for at least five to seven years, or longer if the patient continues to receive treatments.

To learn more, visit How Long Should Good Faith Exam Records Be Retained

Even if your state doesn’t clearly define Good Faith Exam requirements, you’re still generally expected to follow the broader laws governing medical practice — meaning a comprehensive GFE before procedures involving prescription drugs, medical devices, or invasive treatments is legally required in most cases. Undefined regulations don’t make exams optional; oversight typically falls to state medical and nursing boards that interpret whether a treatment qualifies as the practice of medicine, and failing to conduct these exams can expose your practice to fines, unlicensed practice violations, cease-and-desist orders, or loss of delegation authority.

The safest approach when rules are vague is to err on the side of compliance: treat every relevant treatment as requiring a GFE conducted by a licensed MD, NP, or PA, fully document each encounter before treatment, and retain records according to state medical record laws. This proactive strategy protects your license and demonstrates professionalism to both regulators and patients, and helps ensure your practice remains compliant even if laws are later clarified.

To learn more, visit What if my state doesn’t clearly define GFEs?

Not all states treat telehealth Good Faith Exams the same, even though most now allow them under specific conditions.

Telehealth GFEs are generally accepted when conducted via live, synchronous video by a provider licensed in the patient’s state and documented to the same standard as an in-person exam, but state rules vary around supervision, scope of services, and telemedicine definitions. Because some states still impose limitations that can restrict or effectively prohibit virtual exams for certain treatments, practices must confirm state-specific requirements before implementing telehealth GFE workflows.

To learn more, visit Are telehealth GFEs accepted in all states?

Improper delegation of Good Faith Exams can absolutely put your license at risk if it’s done outside the bounds of your state’s medical, nursing, and telehealth laws. Delegation isn’t just “assigning work” — if the person delegated to isn’t licensed to perform GFEs, lacks written supervision agreements, or isn’t properly overseen and documented, boards can view the exam and subsequent treatment as unlicensed practice, exposing the Medical Director and practice to fines, discipline, or loss of licensure.

To learn more, visit Can the delegation of GFEs put my license at risk?

States typically enforce Good Faith Exam (GFE) regulations through oversight by state medical or nursing boards- mainly via random audits, complaint-driven investigations, and review of chart-note documentation. When a patient complaint arises or a board launches an audit, authorities often request the GFE records; missing, incomplete, or improperly documented exams (e.g. exams conducted by unlicensed staff, or using asynchronous methods where synchronous exams are required) can trigger disciplinary action.

Penalties for non-compliance vary by state and severity of the violation, but may include substantial fines (e.g., $5,000 to $50,000 per infraction), cease-and-desist orders, license suspension for the medical director or delegated provider, and public reprimands.

To learn more, visit How do states enforce GFE regulations?

Almost all states require GFEs for medical aesthetic procedures, but the specific terms and formats vary. Only a few states, often those with very narrow definitions of “medical treatment, ”allow exceptions.

No. A medical history is just one component of a GFE. The exam also involves assessment, diagnosis, and approval from a qualified medical professional.

During a Good Faith Exam, the patient meets with a licensed medical provider either in person or virtually. The provider reviews the patient’s medical history, asks questions about current medications and allergies, and conducts a focused assessment of the treatment area. This step ensures the planned aesthetic procedure is medically appropriate and aligns with the patient’s health status and goals.

Bringing prior medical records isn’t always required, but can be very helpful, especially if the patient has had recent surgeries, ongoing prescriptions, or previous aesthetic treatments. Records provide a complete picture of the patient’s health history and may reduce the time required for the GFE.

Most insurance providers do not cover GFEs because aesthetic treatments are considered elective and cosmetic. However, the GFE fee is often modest and may be included in the overall cost of treatment or absorbed by the med spa as part of its intake process.

Yes, GFEs can be done virtually if the state allows it. Some states permit virtual GFEs through telehealth platforms, provided the provider conducts a real-time video evaluation and documents the encounter accurately.

Virtual exams are especially convenient for busy patients and practices that offer same-day treatments. However, some states still require in-person GFEs, so it’s important to check local laws before doing virtual GFEs.

Minors can receive a Good Faith Exam if accompanied by a parent or legal guardian who provides written consent. Providers will also evaluate whether the treatment is age-appropriate and safe for developing skin or tissue.

If the provider determines that a procedure would be unsafe or medically inappropriate, the patient will be advised against proceeding with it. In such cases, the provider may recommend alternative treatments or suggest waiting until certain conditions change (for example, stopping a medication or resolving a skin issue).

Patients should:

• Use a stable internet connection and good lighting.
• Be in a private, quiet space.
• Have a photo ID ready for verification.
• Remove makeup if the treatment area is on the face.
• Be prepared to discuss their health history openly.

These steps help the provider make an accurate assessment and ensure compliance with telehealth standards.

All telehealth GFEs must comply with HIPAA or equivalent state privacy regulations. This means that any video platform used should feature secure encryption and not share data with unauthorized third parties. Reputable med spa partners, such as Spakinect, utilize HIPAA-compliant technology to safeguard patient data at every stage of the process.

Family members or caretakers may join if the patient requests their presence, but the provider must still ensure privacy and obtain the patient’s consent. This can be helpful for minors, elderly patients, or those who prefer emotional support during the call.

Yes. After evaluating the patient’s health and goals, the provider will discuss appropriate treatment options. They’ll explain the benefits, risks, and alternatives, ensuring that the final decision is based on informed consent.

Suppose the GFE reveals contraindications, such as certain medications, pregnancy, or health conditions. In that case, you must explain why the treatment isn’t recommended and suggest alternative options that are safer or more effective for the patient’s situation.

Only licensed medical professionals, such as physicians, nurse practitioners (NPs), or physician assistants (PAs), are authorized to perform GFEs. Medical directors oversee the process, but delegation must always comply with state regulations. While RNs, LPNs, or aestheticians can assist with intake or administrative steps, they cannot independently perform or approve a GFE.

It depends on state law. In many states, NPs and PAs may conduct GFEs independently, while RNs must do so under physician or NP supervision. Some jurisdictions require the medical director to review or sign off on all GFE documentation. Always verify delegation rules with your state medical board to prevent compliance issues.

Efficiency comes from integrating GFEs seamlessly into the patient intake process. Telehealth platforms like Spakinect allow patients to complete their required exam before arrival or while waiting in the office, minimizing downtime. Automating scheduling, reminders, and recordkeeping helps your team stay compliant without sacrificing workflow speed.

Every completed GFE must be documented and stored in the patient’s medical record. The file should include the patient’s health history, physical assessment notes, treatment recommendations, provider credentials, and signed consent forms. Electronic medical records (EMRs) can simplify this process by auto-storing forms and timestamps.

A properly conducted GFE provides legal protection for both the provider and the med spa. It demonstrates that medical judgment was applied before treatment, helping reduce exposure in malpractice claims or audits. Missing or incomplete GFE documentation, on the other hand, can lead to fines, license suspension, or civil penalties.

To control costs, many med spas outsource their GFEs to telehealth partners who handle the evaluation, documentation, and compliance requirements for a flat fee. This eliminates the overhead of hiring full-time medical staff while ensuring all exams meet the relevant standards.

Spakinect integrates directly with leading EMR systems, allowing GFE notes, signatures, and timestamps to sync automatically into patient charts. This digital integration not only streamlines operations but also enhances audit readiness and visibility of compliance, providing you with greater peace of mind.

Most practices only bill for completed exams. However, it’s good business practice to define your billing policy upfront, especially for telehealth appointments where patients may miss or cancel sessions. Some med spas fold GFE costs into their treatment packages to simplify the payment process.

Outsourcing GFEs can save both time and money. By leveraging a compliance partner, med spas avoid costly staffing expenses, reduce liability, and improve scheduling flexibility. The long-term ROI often includes higher patient satisfaction, reduced risk, and smoother operational flow.

When GFEs are built into intake forms and scheduling systems, patients can complete them early in the process before consultations or appointments. This can minimize delays and give providers immediate access to medical clearance.

Automated scheduling tools and on-demand telehealth access help maintain consistent patient flow. Instead of waiting days for clearance, patients can complete their exam in real time and proceed to treatment during the same visit.

By outsourcing GFEs, in-house providers can focus on performing treatments instead of managing compliance paperwork. This boosts productivity and revenue while ensuring all exams meet legal requirements.

Your team members should be trained to understand the purpose of GFEs, recognize their legal importance, and assist with patient onboarding. Even though non-medical team members don’t perform exams, their coordination ensures patients experience smooth, compliant care from start to finish.

GFE validity periods vary by state, but most GFEs remain active for 6 to 12 months. After this period, or if a patient’s medical status changes, a new GFE must be conducted before further treatments can be administered. You also need to conduct a new GFE if you’re introducing a new treatment for the patient.

Yes, patients need a new GFE if treatments change. A new or updated GFE is required anytime the patient requests a different type of treatment. Each procedure involves unique risks, so medical clearance for one service doesn’t automatically apply to another.

Every GFE should be logged in your electronic medical record system with the provider’s name, license number, date of exam, and signed notes. The documentation must clearly show that the provider assessed and approved the treatment plan before any services were performed.

Transparency is essential, but tone matters. Instead of framing the GFE as a “requirement,” describe it as a personalized safety check that protects the patient’s health and ensures optimal results. A simple explanation like, “This quick medical screening helps us tailor your treatment safely,” helps patients feel at ease.

By identifying potential contraindications and ensuring the treatment is suitable, GFEs minimize the risk of complications. They also improve patient outcomes by aligning procedures with each individual’s medical profile and aesthetic goals.

Patients appreciate when compliance feels like an integral part of quality care, rather than just a formality. Presenting the GFE as a value-added service reinforces trust and professionalism. It communicates that your med spa prioritizes safety just as much as results.

Treatment cannot be done if a patient misses their GFE and must be rescheduled. Performing any medical procedure without a completed and documented Good Faith Exam is a compliance violation that could expose the med spa to penalties.

Follow-up notes should document any changes in the patient’s condition, new medications, or additional recommendations from the provider. Maintaining updated records supports ongoing compliance and ensures continuity of care for returning patients.

Transparency and documentation are key to passing state board inquiries. Provide complete GFE records, including patient histories, exam notes, and signed consents, promptly upon request. Avoid editing or adding documentation after the fact. It’s also wise to consult your legal or compliance advisor early in the process to learn more about what to expect.

Both share responsibility, but the supervising medical director usually bears the ultimate legal liability. The provider performing the GFE must act within scope and according to medical standards, while the medical director oversees the overall compliance framework of the practice.

Performing treatments without a completed GFE can result in severe penalties, including license suspension, civil fines, or closure of the medical spa. Repeated violations can lead to criminal charges for practicing medicine without a license.

Keep all GFE documentation organized and easily accessible. Maintain detailed records showing:

• The provider’s credentials and license status
• Date and type of exam performed
• Signed informed consent
• Patient medical history and treatment notes

Auditors look for consistency and completeness. Partnering with compliance-focused vendors like Spakinect ensures your digital records meet state and federal expectations.

When outsourcing, choose a partner that employs licensed providers, adheres to state-specific guidelines, and utilizes HIPAA-compliant technology. Request written documentation of their compliance protocols and audit procedures. Reliable companies, such as Spakinect, maintain detailed policies and integrate directly with your EMR for full transparency.

GFE regulations evolve regularly, sometimes multiple times a year. Staying compliant requires ongoing monitoring of state medical boards and professional associations. Partnering with a compliance company like Spakinect simplifies this process since we can keep up with the regulations to ensure you’re always compliant.

Yes, but the policy should be clearly communicated upfront. Some med spas include the GFE fee in the total treatment price, while others list it separately. Transparency helps avoid confusion and reinforces professionalism. You can also absorb the cost of GFEs or incorporate it into treatment costs to simplify the process.

When patients see that your med spa prioritizes their health through proper medical evaluation, they’re more likely to view your team as trustworthy and credible. The GFE demonstrates that treatments are not just cosmetic choices; they’re medical procedures performed responsibly.

Yes, GFEs help with retention tr. Patients who experience thorough, attentive intake exams are more likely to return and refer others. The GFE sets the tone for a long-term care relationship, positioning your med spa as a reliable, safety-conscious provider.