How to Protect Your Aesthetic and Avoid Costly Legal Mistakes

Running a med spa today isn’t just about offering great treatments. You also need to follow important rules from federal and state agencies. These rules cover privacy, safety, and marketing.

In 2025, 17 states enacted new laws about who can work in med spas and how they must be supervised.

Even making simple mistakes, like forgetting a consent form, hiring someone without proper training, or posting a photo you don’t have permission for, could cost you tens of thousands of dollars, harm your reputation, or even lead to losing your license.

This article is your easy, step-by-step guide to staying safe and growing your business written in collaboration with legal expert Sara Shikhman from Lengea Law. Inside, you’ll learn:

• What federal, state, and local rules apply to your med spa (like HIPAA, OSHA, marketing, and scope-of-practice laws).
• The 4 most common legal mistakes to avoid.
• Real stories of med spas that almost faced legal trouble and what they did right to fix it.
• Simple tools like consent forms, staff checklists, and sample scripts.
• Recommended steps to build a strong foundation that protects your patients, practice, and profits.

By the end, you’ll know exactly how to follow the rules, keep your license, and build a med spa that patients trust, all without feeling overwhelmed. For detailed legal advice for your particular situation please contact Lengea Law.

What does the law expect from aesthetic businesses?

Legal obligations depend on several factors: your state, your license type, and the services you provide. Medical spa owners must comply with laws governing:

• Medical board supervision
• Licensing for providers (MD, NP, PA, RN, etc.)
• Proper delegation of medical procedures
• Storage and documentation of patient health information (HIPAA)
• Marketing rules set by the FTC and state boards

Running a med spa means knowing what services count as medical, and who’s allowed to do them. Some treatments, like Botox, are medical and must be done or watched over by someone with a medical license, like a doctor or nurse. Other services, like facials or skincare, might only need a licensed esthetician. But even then, some states still ask for a doctor to be in charge.

That’s why it’s so important to know your state’s rules. If you let the wrong person do a treatment, you could face legal trouble, even if you didn’t mean to break the law.

Why getting legal advice early is key

Legal mistakes in aesthetic medicine are often made unintentionally. A well-meaning injector might not realize they need a Good Faith Exam (GFE) before treatment. A new practice owner may not know that calling their membership plan “insurance” could trigger a legal review.

That’s why we always consider proactive legal counsel as an essential investment. Aesthetic laws are complex and vary widely by state. Working with a law firm like Lengea Law helps you get it right on day one. Lengea regularly supports aesthetic providers: 

• Draft proper consent forms
• Create compliant employee agreements
• Navigate state-specific supervision laws
• Structure your business correctly (especially if you’re using an MSO model)

In the long run, hiring a legal expert saves more money and stress than dealing with a lawsuit or board investigation.

What Mistakes Could Get You in Trouble?

Even the best med spas can run into legal trouble, not because they’re doing something wrong on purpose, but because they missed a small but important detail. It’s not always big mistakes that cause problems. Often, it’s little things that get overlooked.

Here are 4 common legal mistakes that cost med spas money, patients, and even their license and how to stay safe:

Mistake #1: No Proper Consent Forms

Every treatment, even simple ones, needs a signed consent form. A generic , one-size-fits-all form isn’t enough. You need a separate form for each treatment that includes:

• A description of the treatment 
• The risks and possible alternatives
• Patient initials next to each risk
• Signatures from both the provider and patient

Real example: A patient gets laser skin treatment and gets burned. If there’s no signed form that explains burns are a possible side effect, you might have no legal protection.

Tip: Use clear forms. Go over them with your patient. Keep a signed copy on file. Need consent forms that hold up under board review? Contact Lengea Law.

Mistake #2: Unlicensed Staff Doing Medical Work

Even if your team is experienced and professional , they can only do what their license allows. Some treatments must be done by a doctor, nurse, or licensed provider.

These include:

• Botox or filler injections
• IV hydration therapy
• Laser hair removal
• Microneedling with PRP or radiofrequency

Letting someone without a proper license perform these procedures, even under supervision, can result in disciplinary action, board complaints, or loss of licensure.

Tip: Always double-check your staff’s license and what it allows in your state. Don’t assume your staff’s credentials cover everything. Lengea Law regularly audits staffing structures for med spas to ensure all services are delegated and supervised correctly. If you’re unsure whether your setup is compliant, contact Lengea Law for support.

Mistake #3: Bad Marketing or Photo Use

Marketing laws for med spas are strict, and breaking them, even by accident can get you in trouble with the FTC or your state medical board.

Here’s what to avoid:

• Posting patient photos without signed written permission
• Saying a treatment is “FDA-approved” when it’s not
• Showing off-label drug use (like semaglutide) without explaining it
• Not adding “results may vary” to before-and-after posts

Tip: Be honest, clear, and get consent in writing before using photos or patient stories.

Need help with safe marketing? Ekwa Marketing helps practices like yours grow the right way without breaking the rules.

Mistake #4: No Employee Contracts or Wrong Ones

If you don’t have proper contracts, things can fall apart fast. You need to clearly explain:

• Whether someone is an employee or independent contractor
• How compensation is structured 
• What happens when  someone  leaves
• Confidentiality, non-solicitation, and non-compete obligations. 

Real example: A provider left a med spa and took the client list with them. Because there was no contract or rule against it, the owner couldn’t do anything.

Tip: Use contracts that cover roles, pay, non-solicit rules, and confidentiality. Always have them signed.
Want help setting up your contracts or consent forms? Talk to Sara Shikhman from Lengea Law for expert legal advice  tailored to aesthetic clinics.

Consent Forms and Legal Protection

Consent forms are not just boring paperwork; they’re one of the best ways to protect your business.

When a patient signs a consent form, it shows they understand the treatment, the risks, and that they’ve agreed to move forward. This simple step can stop a lawsuit before it starts.

Why Consent Forms Matter

Giving “informed consent” means your patient knows:

• What the treatment is
• What might go wrong
• What other options they have
• That they’re choosing it on their own

Even if the treatment goes well, a patient can still complain if they say you didn’t explain things clearly. That’s why consent forms are not just a good idea, they’re essential.

Lengea Law helps med spas avoid exactly these scenarios. Throughout drafting and reviewing customized consent forms, Lengea makes sure your business complies with both state and medical board requirements.

What Consent Forms Do You Need?

You need a different form for each service, there is no “one-size-fits-all” form. Here are some important ones:

• Botox and filler consent
• Laser hair removal consent
• Microneedling (with or without PRP)
• IV therapy consent
• Chemical peel consent
• Weight loss shots (like semaglutide)

You also need general forms like:

• HIPAA privacy notice (for patient info)
• Financial policy (how you handle payments)
• Photo/video consent (for marketing or before-and-after use)

Looking for consent forms or agreements? Lengea Law maintains a growing library of treatment-specific, state-compliant consent forms that can be customized to meet the needs of each clinic. See here for Lengea’s available templates. 

How to Structure a Consent Form That Protects You & Your Patients!

A good consent form should be easy to read and include all the facts. It should:

• Explain the treatment in plain language
• List possible risks (common and rare)
• Explain what the patient can reasonably expect 
• Remind them that results may be different for each person
• Present alternative options  (like skipping the treatment)
• Ask for initials next to each risk
• End with signatures from the patient and provider

If you need to review your current forms or draft new ones, contact Lengea Law.  

Where to Keep Consent Forms and How Often to Update Them

Store them safely: Keep each signed form in the patient’s file for at least 5 to 7 years. If the patient is under 18, you may need to keep them even longer.

Use digital tools: Store them in secure, HIPAA-compliant systems like:

• TouchMD
• AestheticsPro
• SolutionReach

Review and update every year: Make sure your forms reflect any new treatments or rules. Ask your lawyer or malpractice insurance provider to review them with you.

Legal Marketing and Photo Use

Marketing helps your aesthetic practice grow, but it also comes with serious legal risks. If you’re not careful, one wrong post could lead to fines, board complaints, or even a lawsuit. That’s why marketing compliance for aesthetic practices is so important. You must follow rules set by the FTC, FDA, and your state’s medical board.

Let’s walk through how to avoid legal risks in marketing your aesthetic practice while still attracting patients.

Can Aesthetic Practices Use Before-and-After Photos Legally?

Yes, but only if you follow the rules. Using photos to show results is powerful, but it’s also where many clinics make mistakes.

Here’s how to use photography the right way:

• Get signed, written consent for each photo or video you post.
  This includes Instagram, Facebook, websites, Reels, Stories, and emails.

• Don’t use filters, change or alter the image.
  You can’t smooth skin, fix lighting, or adjust size. This is considered misleading.

• Add disclaimers like “Results may vary” on every photo.
  It tells viewers that not everyone will get the same result.

• Avoid hurtful or body-shaming language.
  Phrases like “fix your flaws” or “erase saggy skin” may go against advertising ethics.

Following these rules helps ensure that your aesthetic practice can use before-and-after photos legally.

Lenges Law supports many providers on compliant advertising practices, including photo use, disclaimers, and online content. For marketing and business development resources, contact Lengea.

Semaglutide Marketing Legal Issues for Aesthetic Practices

Semaglutide is a popular treatment, especially for weight loss, but promoting it comes with legal rules. Misusing brand names or promising results can lead to semaglutide marketing legal issues for aesthetic practices.

If you use Semaglutide in your clinic, be sure to:

• Avoid calling it “Ozempic” unless it’s prescribed for diabetes.
• Say it’s used “off-label” if offering it for weight loss or cosmetic use.
• Never promise or guarantee specific results like “Lose 20 pounds fast”.
• List all risks and side effects clearly on your website and in marketing.

To stay compliant regarding GLP-1s, reach out to Lengea Law. Lengea frequently publishes updates on GLP-1 compliance through blog posts and webinars to help providers navigate evolving regulations.

Legal Rules for Testimonials and Social Proof

People love reading reviews, but testimonials are also regulated.

Make sure your reviews are:

• Honest and real – never made up or written by staff.
• Not paid or discounted unless clearly labeled.
• Used with permission – especially if it’s a message, email, or DM.
• Not misleading – don’t say results are “typical” unless you can prove it.

Marketing compliance for aesthetic practices includes what others say about you, not just what you post yourself.

Where Most Aesthetic Practices Go Wrong!

Many clinics run into legal issues because they:

• Hire marketers who don’t understand healthcare rules
• Post content without a review process
• Reuse captions or graphics from other clinics without checking the facts
• Use basic photo release forms that don’t follow medical marketing laws

Need help auditing your marketing, testimonials, or reviews? Contact a team member at Lengea Law to make sure your online presence is legally compliant.

Quick Safety Checklist for Your Marketing

• Have signed consent for all patient photos
• Don’t edit or retouch images
• Use clear, honest language
• Add disclaimers like “Results may vary”
• Review every post before it goes live
• Train your team on legal do’s and don’ts

Want to stay compliant and grow fast?

Ekwa Marketing has over 18+ years of experience helping aesthetic practices like yours grow legally and effectively. Book a Free Marketing Strategy!.

How to Handle Patient Complaints and Adverse Events

Even if you do everything right, things can still go wrong. Patients may have bruising, swelling, burns, or allergic reactions after treatment. Sometimes they’re just unhappy with the results. That’s why knowing how to handle adverse events in an aesthetic practice is so important.

What your team does in these moments can either build trust or cause big legal problems.

You Need a Patient Injury and Complaint Plan!

Every med spa needs a clear, written plan for handling patient problems. This is called a patient injury protocol or complaint response plan, and it should be part of every team member’s training.

Here’s what your plan should include:

• Who will talk to the patient – Is it the front desk, the provider, or a manager?
• How fast you respond – Try to contact the patient right away or schedule a check-up quickly.
• What you document – Take notes, photos, and write down what the patient says.
• When to call in the medical director or a lawyer – Some situations require legal guidance. 

Having this step-by-step plan keeps everyone calm. It helps make sure every case is handled the same way, whether it’s a small issue or something more serious. Whether you need a full plan or a quick review of your current process, contact Lengea Law for a free 15-minute consultation.

Easy Ways to Reduce Legal Risk When a Patient Is Upset!

How your staff speaks to a patient after an issue can make all the difference.  Good communication prevents small concerns from turning into serious complaints. 

Here are smart ways to respond:

• Say thank you and listen
  Try this: “Thank you for telling us. We care about how you’re feeling.”

• Don’t get defensive
  Never say things like, “That never happens,” or “You must’ve done something wrong.”

• Don’t make promises you can’t keep
  Instead of , “We’ll make it perfect,” say: “Let’s schedule a visit to check on your healing.”

• Follow up after the visit
  Call or message the patient a day or two later to ask how they’re doing. Showing care and small gestures can go a long way if there’s ever a legal complaint. 

Train Your Team to Handle Complaints the Right Way

The best way to keep patients happy and your practice protected is to train your team on complaint response protocols.

Your training should include:

• Sample scripts – Teach staff what to say when a patient is upset.
• An “incident checklist” – A list of steps to take when something goes wrong.
• How to use treatment notes and photos – So everyone has the facts.

If there’s ever a legal investigation, this kind of training shows that your team was prepared and acted professionally. Lengea Law can provide you with employment handbooks and HR documents, while supporting in the case of any board investigations or patient complaints. 

Quick Checklist for Handling Adverse Events

• Stay calm and listen to the patient
• Don’t blame or make excuses
• Follow your injury and complaint protocol
• Take photos and write notes
• Follow up after 1–2 days
• Train your whole team on these steps

Need expert legal advice for handling tough patient situations?
Talk to Sara Shikhman — a top attorney at Lengea Law who helps med spas avoid legal trouble and protect their practice.

Hiring and Compensating Your Staff

Your team is the heart of your practice. From injectors to front desk staff, every person who talks to a patient represents your brand and your legal safety. That’s why you need the right contracts, fair compensation plans, and smart hiring strategies.

Step 1: How to Hire a Team Member the Safe Way

Every person on your team should have a written contract. Whether they are a doctor, injector, esthetician, or assistant, the contract must explain their job and protect your business.

Here’s what to include:

• Job duties: Say exactly what they can and can’t do. This depends on their license and your state’s rules.
• Pay plan: Explain if they earn a salary, hourly pay, or commission. Make sure this follows your state’s fee-splitting laws.
• Ending a job contract: Include a rule about how either of you can end the contract, and how much notice is needed.
• Privacy: Add a promise that they won’t share private business or patient info.
• Non-solicit or non-compete: You may want a rule that says they can’t take your patient list or open a clinic next door. Some states don’t allow non-compete agreements, but non-solicit rules can help.

Lengea Law can support you by drafting employment contracts, independent contractor agreements, and non-compete clauses that comply with your state’s employment and healthcare laws. 

Step 2: Building the Right Compensation Plan

Your aesthetic practice compensation model must follow the law and be easy to understand.

Here’s what a good plan looks like:

• Put it in writing – Never leave pay plans to word of mouth.
• Match it to job type – For example, W-2 employees should be treated differently than 1099 contractors.
• Pay fair market value – Make sure you’re paying what’s fair for your area and legal for your state.

Step 3: Training Reimbursement Agreement for Aesthetic Staff

Let’s say you pay for someone to take a special class, like advanced Botox or filler training. What if they quit right after?

To protect your investment, add a training reimbursement agreement to their contract.

This agreement should say:

• How much you’re paying for their training
• How long they must stay after the training (for example, 6 or 12 months)
• How much they must pay you back if they leave early

Bonus Tip: Train Your Whole Team on the Rules

Once your contracts and pay plans are in place, talk about them often. Your team should know:

• What’s expected of them
• How they’re being paid
• What happens if they leave early

This builds trust, avoids confusion, and keeps your practice legally safe.

What You Must Know Before Opening an Aesthetic Practice

Opening a med spa or aesthetic clinic is exciting, but the rules can be tricky. Before you treat your first patient, you need to make sure your practice is safe, legal, and fully compliant.

Let’s break down everything you need to know about aesthetic practice legal requirements so you can open your clinic the right way and protect your business.

Not All Licenses Are the Same

Doctors, nurses, and other providers all have different legal rules. This is called provider compliance by license type. Here’s a quick breakdown:

• MDs (Doctors) – Can own and run aesthetic clinics in all 50 states.
• NPs (Nurse Practitioners) – Can work on their own in some states. In others, they need to work under a doctor.
• PAs (Physician Assistants) – Must work with a supervising doctor in most states.
• RNs (Registered Nurses) – Can do treatments like Botox or laser—but only under a doctor’s supervision.
• LPNs (Licensed Practical Nurses) – Need close oversight and usually can’t work alone.

Lengea Law provides scope-of-practice guidance for different licenses and services to help your team stay compliant across multiple states.

Scope of Practice: What You’re Allowed (And Not Allowed) to Do

Your scope of practice means the types of treatments your license allows you to perform. This changes depending on where you live.

Examples:

• In Texas, RNs need special training and a doctor’s oversight to do laser hair removal.
• In California, only certain licensed providers can use advanced lasers.

Before offering things like Botox, IV drips, or microneedling, double-check that you and your team are allowed to do it.

Who Can Own An Aesthetic Practice?

This is where practice ownership rules matter.

• In many states, only licensed doctors can own a medical practice.

If you’re not a doctor, you may need to use something called an MSO (Management Services Organization). This lets you run the business side like marketing and hiring,while a licensed doctor runs the medical part.

Different Types of Clinics = Different Rules

Not all med spas are the same. Here’s what you might need based on your clinic type:

• Med Spa: You’ll likely need a medical director, proper provider licenses, a HIPAA compliance plan, and clearly written Standard Operating Procedures (SOPs) for your treatments.
• Dermatology Practice: You’ll need a board-certified medical doctor (MD), a charting or electronic medical record (EMR) system, and partnerships with labs for testing or pathology if needed.
• Plastic Surgery Practice: You must have facility accreditation, follow state and local surgery permits, and meet strict rules for anesthesia safety and setup. Each one has special legal requirements, insurance needs, and setup steps. Don’t skip them.

Setting Up Your Business the Right Way

When starting an aesthetic practice, you need to pick the best business structure:

• LLC – Easy to set up and protects your personal stuff.
• S-Corp – Good if you’re the only owner and want tax savings.
• C-Corp – Better for bigger clinics or investor-backed businesses.

If you’re working with partners, write everything down in a legal agreement. No handshake deals! To set up with legal protection, Lengea Law helps with formation, operating agreements, investor contracts, and multi-state expansions. 

Don’t Forget These Legal Must-Haves!

Make sure you also take care of:

• Business license
• Facility license (if needed)
• Liability insurance for the practice
• Malpractice insurance for each provider
• Supervision plans if you have RNs or NPs
• A signed contract with your medical director (if you need one)

Lengea maintains a state-by-state list of potential medical directors to help you staff compliantly. Contact Lengea Law today. 

Other Rules to Watch Out For

Some states have extra rules that many new owners forget about:

• Signage laws – You may not be able to use words like “clinic” unless a doctor owns the business.
• HIPAA – Keep patient info safe with private rooms, strong passwords, and encrypted software.
• OSHA – Train your team on blood safety, gloves, and what to do if someone gets hurt.

Make a Safety Plan for Your Team and Patients

Create Standard Operating Procedures (SOPs) for everything. Each provider should know:

• What to do in an emergency
• How to care for patients after treatments
• What to chart and document
• Who can do what (delegation policies)

Pro Tip: Make a binder for each license type on your team with all the rules they need to follow. That way, no one has to guess what’s allowed.

Not sure where to start? Lengea Law can assemble your entire launch package: licenses, insurance, SOPs, and medical director contracts. Lengea can also help you prevent investigation responses, HIPAA audits, and OSHA complaints from the start. 

What Is the Law called “Corporate Practice of Medicine”?

Some states follow a law called the corporate practice of medicine. This means only licensed doctors, like MDs or DOs can own a business that provides medical treatments.

That includes:

• Botox
• Fillers
• Lasers
• Microneedling with PRP or RF
• IV drips
• Semaglutide for weight loss

If you’re not a doctor, you can’t legally hire or supervise people doing these services in those states.

Example: A salon in California that offers Botox without a doctor involved is breaking the law even if the injector is licensed.

States Where Only Doctors Can Own a Med Spa

These states have strict aesthetic ownership laws:

• California
• Texas
• New York
• New Jersey

In these places, if you’re not a doctor, you’ll need to use a legal structure called an MSO. These ownership and control rules can be complex, and the right setup depends on your exact model. Reach out to Lengea Law before you open your doors. 

What Is an MSO and How Does It Work?

An MSO stands for Management Services Organization. It’s a legal way for non-doctors to help run the business side of a med spa without breaking the corporate practice of medicine rule.

Here’s how it works:

• A doctor owns the medical part of the practice and oversees all treatments.
• The MSO (you) owns the business side; marketing, rent, staff, and scheduling.
• The doctor pays the MSO a fee to manage everything else.

As long as the doctor controls medical decisions and patient care, this setup is legal in most states. However, structuring this incorrectly can lead to enforcement, license risk, or financial penalties. Talk to Lengea Law first to implement compliant MSO structures tailored to your state’s requirements. 

What Are GFE Laws?

GFE means Good Faith Exam. Before any medical treatment, a licensed provider must evaluate the patient’s health and determine whether the treatment is appropriate. 

This exam must be:

• Performed by a doctor, nurse practitioner (NP), or physician assistant (PA)
• Conducted in-person or by video, depending on the state 
• Documented clearly in the patient’s chart

If you skip the GFE, you could get in trouble even if the treatment goes well. Sara Shikhman at Lengea Law regularly advises med spas on how to structure GFE protocols that comply with state-specific laws. Lengea also publishes compliance updates as state boards revise their GFE policies, including which providers may perform the exam and whether telemedicine is allowed. 

State-by-State Aesthetic Rules Are Different from Each Other

Every state has its own rules. These are called state-by-state aesthetic rules. They cover things like:

• Lasers – Who can use them and what kind?
• Injections – Can RNs do them, or only NPs or PAs?
• IV Therapy – Who can give it, and how must it be stored?
• Semaglutide – What’s the right way to offer it for weight loss?

Example: In Florida, RNs can give Botox if a doctor says it’s okay. In Illinois, RNs can’t do it at all, only NPs or PAs can.

Always check your state medical and nursing boards before offering new treatments.

What About Estheticians and Other Staff?

Licensing boards are different for each role:

• Estheticians – Usually can’t use lasers or inject.
• RNs – May need close supervision.
• NPs – Sometimes can work alone, but not in every state.
• Medical Assistants – Cannot do medical treatments on their own.

Check your state’s rules. Fines for unlicensed practice can be big and violations may affect your license in other states too.

How to Stay Safe with State Rules

Each state has websites for its medical, nursing, pharmacy, and cosmetology boards. Look for:

• Scope of practice rules
• FAQs and advisory opinions
• Supervision rules for each license

If you’re not sure, contact the state’s board or reach out to Legea Law or legal guidance on state-specific scope of practice and licensure questions. 

What If You Work in More Than One State?

If your business or your providers operate in multiple states, one mistake in one state can affect your license in others.

This is especially true if your team has compact licenses (shared between states). That’s why it’s important to:

• Report any board actions right away
• Follow the most strict rule if working across states
• Keep all team licenses in good standing

Want real stories?  Sara, a lawyer and former med spa operator, shares how she helped grow a single-room aesthetics practice into a 12-location business generating $13 million annually, all while managing legal complexities in the field. Listen to the full episode here

Final Tip: Talk to an Expert First

Opening and running a med spa the right way takes planning. If you’re not sure what the laws are in your state, talk to a healthcare attorney. They can help you follow the law and protect your business.

Need legal support? Reach out to Sara Shikhman—a top attorney for aesthetic practices and managing partner at Lengea Law. 

FAQs That Every Aesthetic Practice Owner Must Be Aware Of!

If you own or help run a med spa, you’ve probably asked some of these important legal questions. This guide answers the top aesthetic clinic legal questions in simple language, so you can stay safe, grow your business, and avoid big mistakes.

1. Can I Hire an RN or Injector as a Contractor?

You can only treat someone like a “contractor” (1099) if they:

• Set their own work hours
• Bring their own tools or supplies
• Pay their own taxes and insurance

Caution: If you treat them like an employee (W-2), but call them a contractor, you could get into trouble with taxes and the law. Ask a lawyer or HR expert before you decide.

2. Do I Need a Medical Director?

Yes, if you’re not a doctor and your clinic offers medical treatments like:

• Botox or fillers
• Laser treatments
• Weight loss shots like Semaglutide

Your medical director agreement should explain:

• Who handles clinical care
• When they’re available
• What they get paid
• Who is responsible if something goes wrong

Lengea Law can assist not only with drafting and revising your medical director agreements, but also assist with helping you find a qualified medical director in your state. 

3. Can I Post Before-and-After Photos Online?

Yes, but only if:

• The patient signed a photo release form
• You write “results may vary” under the photos
• You don’t edit the photos to make them look better
• You don’t say or show anything that’s misleading

Never use someone else’s pictures (like stock photos or Instagram posts) unless you explain where they came from.

4. Is It Legal to Offer Off-Label Treatments or Compounded Medications?

Yes, but you need to be careful.

Doctors can prescribe “off-label” treatments, but:

• The provider must know the risks and benefits
• You must tell the patient it’s off-label (get written consent)
• Your malpractice insurance should cover it
• You can’t advertise it in a misleading way

For compounded medications (like weight-loss shots), check if your state or FDA has special rules. Use only licensed pharmacies and document everything. Before offering off-label or compounded medications, speak with an attorney at Lengea Law to confirm it’s legally allowed and compliant. 

5. What Should I Do If a Patient Gets Hurt or Has a Bad Reaction?

First, stay calm. Then:

• Write down what happened (include notes, photos, and times)
• Follow your clinic’s written safety plan
• Offer to see the patient for a follow-up
• Call your insurance company if needed
• Make sure your team knows how to talk to the patient kindly and clearly

6. What Consent Forms Do I Need?

You need a special form for each treatment, like:

• Botox
• Fillers
• Laser
• IV therapy
• Chemical peels

Every form should include:

• What the procedure is
• Possible side effects
• Aftercare steps
• Space for the patient to sign and write their initials

Keep the forms safely stored for at least 5 to 7 years. Visit Lengea Law’s website to purchase customizable consent forms tailored to your practice’s needs. 

7. Can I Pay My Team Based on Sales or Revenue?

Sometimes. But be careful, some states don’t allow “fee-splitting” between people who aren’t licensed medical providers.

To stay safe:

• Use clear pay plans (flat rate or simple bonuses)
• Don’t tie pay only to money earned
• Get help from a lawyer when writing contracts

8. What Happens If I’m Audited or Investigated by Regulators?

Being audited by the FTC, state medical board, or health department can happen, especially if something goes wrong:

• Stay organized: Keep accurate records of staff credentials, supervision logs, medical director availability, patient consents, and marketing claims.

• Have a risk management system: Regularly review policies, protocols, waste disposal, emergency care, and privacy procedures. It’s smart to conduct internal audits and get legal counsel annually.

• Respond promptly: If regulators request info, gather it quickly, stay calm, and consult your attorney before responding.

Being proactive with risk management, regulatory audits, and compliance systems can help you avoid fines or license issues, and show regulators you’re serious about patient safety.

9. Do All Team Members Need Malpractice Insurance?

Yes. Your clinic’s insurance may cover the business, but each licensed team member like a nurse, PA, or NP should have their own insurance too.

It protects them, and it protects your business.

10. Can I Use a Name That Sounds Like a Doctor’s Office?

Only if you’re legally allowed to. Names like:

• “Medical Spa”
• “Clinic”
• “Dr. Smith’s Aesthetics”

…might not be okay unless a real doctor owns the clinic or is always there.

Some states have laws about this, so contact Lengea Law before you choose your brand name. Your brand is one of your most valuable assets. Lengea can provide name clearance, trademark registration, and brand protection, so you can grow your business with confidence

More about Text Message Compliance

Texting your patients can be a great way to remind them about visits, share special offers, or stay in touch. But if you don’t follow the TCPA rules (Telephone Consumer Protection Act), you could get into legal trouble and owe thousands of dollars.

Let’s keep your practice safe and legal. Here’s what you need to know.

What Is the TCPA?

The TCPA is a law that protects people from unwanted texts and phone calls. Before texting patients, you must:

• Get written permission from them to send marketing texts
• Make sure the consent is easy to read and not hidden in fine print
• Always include an opt-out option like: “Reply STOP to unsubscribe”
• Only text between 8 AM and 9 PM in the patient’s local time

These rules are part of what’s called opt-in law, people must say “yes” before you text them about anything promotional.

What Happens If You Don’t Follow the Rules?

If you send a text without permission, it can cost you:

• $500 per message if it was a mistake
• Up to $1,500 per message if it was on purpose
• Some clinics have paid millions in lawsuits because of this

Safe “Text Compliance” Checklist for Your Med Spa

Use this list to make sure your clinic is texting the right way:

• Got written opt-in from the patient
• Used a separate checkbox just for text consent
• Keep logs or proof of when they said yes
• All texts include a way to opt out
• Follow all TCPA rules and keep language clear

Pro Tip: Use tools like Solutionreach, SimpleTexting, or ActiveCampaign. These help you manage consent, follow opt-in laws, and track messages safely.*

Need help staying compliant with your marketing? Ekwa Marketing has over 16 years of experience helping aesthetic practices like yours grow legally and effectively. Learn more about Ekwa Marketing.

Why Legal Safety Makes Business Stronger

Legal rules might seem boring or hard but they’re actually one of your best tools for business growth. When your med spa follows the right laws and protects patients, you build something strong and safe. That means more trust, fewer problems, and more success in the long run.

Here’s why:

Following the Rules Builds Patient Trust

People want to feel safe when they come to your clinic. When you use:

• Clear forms for each treatment
• Honest prices
• Well-trained team members

…your patients trust you more.

And when your patients trust you, they keep coming back and they tell their friends too.

Avoiding Lawsuits Saves Big Money

Lawsuits, fines, and legal trouble can cost thousands of dollars. Even one mistake like missing a consent form or using the wrong photo can hurt your wallet and your reputation.

Good risk management means:

• Getting legal help before problems happen
• Having a plan for patient complaints
• Training your team to follow safety steps

That’s smart business. You deserve legal support that understands your business, answers your questions, and helps you grow with confidence. Contact Lengea Law for personalized guidance, real healthcare industry experience, and a team-based approach.

Strong Systems Help You Grow

If your practice is messy, it’s hard to grow. But when your team knows the rules, your contracts are clear, and your policies are ready, you can:

• Open more locations
• Offer new treatments
• Work with investors or partners

This is how smart clinics grow fast and safely.

Pro Tip:

Don’t think of legal rules as extra work. Think of them as your practice’s armor. Every policy and contract you create helps your business stay strong and ready for what’s next.

Need help with legal questions?

We recommend talking to a legal expert like Sara Shikhman at Lengea Law, who knows the aesthetic world inside and out. Contact Sara Shikhman to protect your clinic and support your business goals. 

Additional Resources & References

1. Marketing and Advertising Rules for Med Spas – SearchMedSpas.com
2. FTC Enforcement for Health Claims in Aesthetic Practices – JD Supra
3. Corporate Transparency Act: What Med Spa Owners Must Know – Lengea Law
4. BOI Rule Update and Exemptions – FinCEN.gov
5. FTC/FDA Ad Compliance Checklist for Medical Spas – MedSpaMastery.co