The Good Faith Exam: Who Can Perform It, When It's Required and What to Document

The good faith exam (GFE) is one of the most misunderstood requirements in aesthetic practice. It's also one of the most common issues in Board accusations. Here's what every aesthetic nurse should know.

What Is a Good Faith Exam?

A GFE is a legal medical assessment. In California, it's the "appropriate prior examination" required under Business and Professions Code § 2242 before prescription drugs or devices are used. A GFE:

• Establishes the provider-patient relationship before treatment.
• Reviews the patient's medical history, overall condition and specific needs.
• Documents a medical indication for the planned treatment.
• Supports sound medical judgment and prevents misuse of prescription drugs and devices.

Other states have their own rules; check yours.

Who Can Perform It?

Authorized providers can make a medical diagnosis and prescribe treatment:

• Physicians
• Advanced practice registered nurses, such as nurse practitioners
• Physician assistants

Each must have knowledge, training and experience in the specific treatment they're assessing for, including how to manage its adverse events.

Registered nurses are not authorized to perform good faith exams. RNs may assess within their nursing scope but can't assess for medical diagnosis, planning or prescribing.

When Is It Required?

• Every new patient in the practice.
• Existing patients seeking a new treatment they haven't received at your practice. For example, a patient who has had neuromodulator treatments and now wants dermal filler needs a GFE for filler.
• When things change. Repeat the assessment after a medical history change, new concerns from a previous treatment, or a reported adverse reaction.

If a patient returns for the same treatment with no medical changes, a licensed provider authorized to perform that treatment, including an RN, may proceed.

How Can It Be Done?

• In person
• By video (telehealth)
• Asynchronously in specific cases, with photographs, as long as all information is documented and provided

A medical history review alone is not a completed GFE. The provider must interact with the patient and do a visual assessment.

What to Document

• Date, time and method (in person or remote)
• Examining provider's name, credentials and authorization
• Relevant medical history, contraindications and treatment plan
• Informed consent and patient understanding
• The medical indication

Best Practices

• Repeat GFEs yearly, even for returning patients.
• Use one standardized exam protocol for every patient. Consistency also helps reduce implicit bias.
• Train staff regularly on GFE requirements.

Skipping or mishandling the GFE can lead to charges of practicing medicine without a license and scope-of-practice violations.

Learn More: The Good Faith Exam (1 Contact Hour)

California BRN Provider #18009. Your certificate appears on your dashboard after you submit the course evaluation, and it's emailed to you.

Need GFE protocols and documentation templates for your practice? Visit AestheticNursingPnP.com

Educational information only, not legal advice. Requirements vary by state; confirm with your state board.

Sources

• The Good Faith Exam course (Aesthetic Nursing Policy & Procedures, Inc.)
• [California Business and Professions Code § 2242](https://leginfo.legislature.ca.gov/faces/codes_displaySection.xhtml?lawCode=BPC&sectionNum=2242)
• [Medical Board of California, Cosmetic Treatments FAQs](https://www.mbc.ca.gov/FAQs/?cat=Licensees&topic=Cosmetic%20Treatments)