Good faith exam (GFE)
A good faith exam is the initial clinical evaluation a licensed clinician performs before a patient receives a medical treatment — the visit that establishes the patient relationship, confirms the treatment is appropriate, and authorizes it.
- Establishes the prescriber-patient relationship
- Required before most medical treatments in med spa settings
- Can be async or synchronous depending on state and treatment
- Documentation is what makes it defensible
Where the term comes from
The phrase is most used in the med spa and aesthetics world, where state rules require a physician, NP, or PA to evaluate a patient before an injector or aesthetician performs a medical procedure. It has migrated into telehealth generally as shorthand for “the exam that makes a prescription lawful.”
For a telehealth program the good faith exam is the first encounter: intake reviewed, questions asked, contraindications screened, and a clinician deciding the treatment fits. Whether it can be asynchronous depends on the state and the treatment.
What makes an exam “good faith”
A real evaluation by a clinician licensed in the patient’s state, with enough information to meet the standard of care for the treatment in question, documented in a note that shows what was considered. A questionnaire nobody reviews is not one; a clinician reviewing a well-built intake usually is.
- Licensed clinician in the patient’s state
- Identity verified; consent captured
- History, medications, contraindications reviewed
- A documented decision, not just a prescription
GFE vendors versus full infrastructure
Some vendors sell the exam alone — an embeddable consult a med spa can order per patient. That solves the evaluation but not the prescription, pharmacy, refill cycle, or record. Programs that ship medication to patients usually need the exam as the first step of a full clinical pipeline rather than a standalone product.
Compliance handled, so you can build
Lithos runs the clinicians, pharmacies, and 50-state rules behind your care program — one API.
Frequently asked questions
Is a good faith exam required for telehealth prescriptions?
An initial clinical evaluation by a licensed clinician is required before prescribing in every state; “good faith exam” is the common name for it in aesthetics and med spa settings. State rules decide whether it can be asynchronous.
Can a nurse or aesthetician perform a good faith exam?
Generally no. The exam must be performed by a physician, NP, or PA acting within their scope; a nurse or aesthetician may perform delegated treatments after it.
How often is a good faith exam needed?
Once to establish the relationship and authorize a treatment plan, then re-evaluation at intervals set by protocol or when the treatment changes. Many states require a new evaluation annually.