Opening a med spa or aesthetic clinic involves far more than leasing a suite and buying equipment. Between entity structure, physician oversight, staff credentialing, and treatment-specific protocols, it's easy to miss a requirement that only surfaces later — usually during a board inspection or a due diligence review.

This checklist walks through every category to confirm before you open, with links to deeper guides on each one.

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1. Business & Ownership Structure

☐  Confirm whether your state requires physician ownership of the clinical entity. In strict Corporate Practice of Medicine (CPOM) states, non-physicians cannot directly own the practice — see our guide to physician-owned entities and CPOM compliance.

☐  Choose your entity structure — a PC/MSO split in CPOM states, or a standard LLC/corporation elsewhere

☐  Register your business name and obtain an EIN

☐  Confirm your state's specific business licensing requirements for medical aesthetic facilities

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2. Medical Director

☐  Confirm your state's specific requirement — almost every state requires a licensed Medical Director for a med spa. See our full breakdown of Medical Director requirements for med spas.

☐  Verify the physician holds an active, unencumbered license in your state, with a specialty that reasonably aligns with your treatment menu

☐  Get signed, facility-specific clinical protocols for every treatment category you offer — not a generic template

☐  Establish a documented chart review schedule and defined response times in writing

Budgeting for this line item? See our breakdown of what a Medical Director actually costs in 2026.

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3. NP/PA Collaboration (If You're Employing Them)

☐  If nurse practitioners or physician assistants will be performing or overseeing treatments, confirm your state's collaboration requirements — 22 states require a collaborating physician for NPs, and all 50 states require a supervising physician arrangement for PAs. See our state-by-state guide to collaborating physician requirements for NPs.

☐  Confirm what this actually costs and what should be included — see current NP/PA Collaboration pricing.

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4. Clinical Protocols & Standing Orders

☐  Written protocols and standing orders for every treatment category on your menu — injectables, laser, body contouring, and any others

☐  Contraindication screening documented for each treatment category, not assumed from staff training

☐  Offering GLP-1 prescribing? You'll need Good Faith Exam protocols specific to that program — see our GLP-1 Medical Director requirements guide.

☐  Offering IV hydration? Standing orders need dose ranges, contraindications, and a re-sign cadence — see our IV hydration standing orders guide.

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5. Consent Forms & Patient Intake

☐  Treatment-specific informed consent forms — not a single generic waiver covering every service

☐  Documentation process for before/after photos and marketing use of patient images

☐  Intake forms that capture medical history relevant to contraindication screening

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6. Staff Credentialing

☐  Active license verification for every clinical staff member before they treat a single patient

☐  A process for ongoing (not just one-time) license monitoring

☐  Documentation confirming each staff member is trained and authorized for the specific procedures they perform

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7. Facility & Equipment Compliance

☐  State-specific facility licensing for medical aesthetic practices

☐  Equipment registration or certification requirements (several states require this for lasers and certain devices)

☐  Sterile compounding compliance (USP 797) if mixing injectables or IV additives on-site

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8. Insurance

☐  Malpractice/professional liability coverage for the practice and each clinical provider

☐  General liability and property coverage for the facility

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9. Marketing & Advertising Compliance

☐  Confirm any “board certified” or credential claims in your marketing are accurate and defensible

☐  Written consent on file before using any patient photos or testimonials in advertising

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10. Pre-Launch Final Review

☐  Walk through your documentation as if a board inspector asked for it today — agreements, protocols, chart review logs, licenses

☐  Confirm every item above has a document behind it, not just a verbal understanding

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How Access Plus Health Helps You Check These Boxes

Access Plus Health has supported 500+ businesses nationwide in opening compliant med spas and aesthetic clinics — handling the Medical Directorship, NP/PA collaboration, and entity structuring pieces of this checklist as a single, flat-fee arrangement.

• Board-certified Medical Director matched to your treatment menu and state
• Physician-owned entity (PC) and MSA structuring for CPOM states
• NP/PA collaboration or supervision agreements where needed
• Facility-specific protocols and standing orders for every treatment category

To get a checklist review specific to your state and services, visit accessplushealth.com/pricing or call (213) 205-0946.

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