Question 1

Is an exam required before a patient can be treated in Alabama?

Accepted Answer

ALABAMA PUTS THE CONSENT DUTY ON THE DELEGATING PHYSICIAN AND NAMES WHAT IT MUST COVER. Before a delegated non-ablative treatment the physician must ensure the patient is adequately informed and has SIGNED a consent form setting out Risks, Benefits, Alternatives and Complications — including reasonably foreseeable side effects, AND THE NAME OF THE DEVICE AND THE PROCEDURE. The protocol must also carry SELECTION CRITERIA to screen patients for the appropriateness of a non-ablative treatment. On the clinical side, obtaining patient histories, performing physical examinations, formulating a working diagnosis and developing a treatment plan are named services a physician assistant performs under delegation from the supervising physician. (Ala. Admin. Code r. 540-X-11-.05(3) (Written protocols — patient selection); verified 2026-09-04) This is regulatory monitoring, not legal advice.

Question 2

Is an exam required before a patient can be treated in Alaska?

Accepted Answer

AS 08.64.364 reaches the pre-treatment examination from the opposite direction to most states: rather than requiring an exam, it tells the Medical Board when it may NOT discipline a physician or physician assistant for prescribing without a physical examination. The safe harbor sets two conditions: the prescriber or another licensed provider in the practice must be available for follow-up care, and the prescriber must ask the person to consent to sending the encounter records to their primary care provider — and send them if the person consents — where the prescriber is not that provider. Two limits matter for a med spa: the drug must not be a controlled substance for the (a) safe harbor to apply on its own terms, and no PHYSICIAN OR PHYSICIAN ASSISTANT may prescribe, dispense or administer in response to an INTERNET QUESTIONNAIRE or email to a person with whom they have no prior physician-patient relationship. The chapters quoted here scope that bar to physicians and physician assistants; they do not establish what binds other licensees. (AS 08.64.364(a) (Prescription of drugs without physical examination); verified 2026-09-05) This is regulatory monitoring, not legal advice.

Question 3

Is an exam required before a patient can be treated in Arizona?

Accepted Answer

Arizona states a condition: a prescription-drug injectable needs an order from an AUTHORIZED PRESCRIBER acting within the standard of care. The telehealth statute lets the relationship be established and the drug prescribed remotely ON DOCUMENTED INFORMED CONSENT — with Schedule II drugs the one situation where a board may still require a prior in-person examination. The consent requirement is a precondition and it is explicit: except as subsection G provides, BEFORE a health care provider delivers health care through telehealth the treating provider must obtain verbal or written informed consent, including by electronic means, from the patient or the patient’s health care decision maker — and must DOCUMENT it on the medical record if it was given verbally. All medical reports resulting from a telehealth consultation are part of the patient’s medical record. (A.R.S. §32-1401(27); verified 2026-07-26) This is regulatory monitoring, not legal advice.

Question 4

Is an exam required before a patient can be treated in Arkansas?

Accepted Answer

ARKANSAS PUTS THE DIAGNOSIS ON THE PHYSICIAN PERSONALLY, AS THE FIRST STEP OF THE LASER PROTOCOL. Within that laser rule, before a delegated minor procedure the physician must PERSONALLY diagnose the condition of the patient and prescribe the treatment and procedure to be performed. The delegation rule reaches the same place from the other direction: before delegating anything the physician must determine that the task is indicated for the patient and fix the appropriate level of supervision, and where drugs are involved must evaluate the acuity of the patient and judge that delegation is appropriate at all. (17 CAR § 140-3201(a) (Telemedicine — patient/provider relationship); verified 2026-09-04) This is regulatory monitoring, not legal advice.

Question 5

Is an exam required before a patient can be treated in California?

Accepted Answer

California requires an appropriate good-faith exam before prescriptive drugs or devices are used — and it may not be delegated to an RN. (Cal. Bus. & Prof. Code §2242(a); verified 2026-07-26) This is regulatory monitoring, not legal advice.

Question 6

Is an exam required before a patient can be treated in Colorado?

Accepted Answer

⚠️ READ THE LIMIT ON THIS SECTION FIRST. ARTICLE 240 imposes no pre-treatment examination requirement — but the Colorado Medical Board’s rules (3 CCR 713) are published on a host whose robots.txt disallows the rule-display endpoint, so WE HAVE NOT READ THEM and claim no absence about them. What follows is what the STATUTE provides. (Colo. Rev. Stat. art. 240 of tit. 12, surveyed in full; the examination provisions are at § 12-240-125; verified 2026-09-02) This is regulatory monitoring, not legal advice.

Question 7

Is an exam required before a patient can be treated in Connecticut?

Accepted Answer

Connecticut requires an initial IN-PERSON physical assessment of every person before a cosmetic medical procedure is performed at a medical spa, and it must be performed by the physician, physician assistant or advanced practice registered nurse the spa employs or contracts with. The word “in-person” was added to the statute by amendment, so a remote assessment does not satisfy it. (Conn. Gen. Stat. §19a-903c(c); verified 2026-09-03) This is regulatory monitoring, not legal advice.

Question 8

Is an exam required before a patient can be treated in Delaware?

Accepted Answer

Delaware puts its telehealth rule in a chapter of its own. A provider-patient relationship must exist before health-care services are delivered by telehealth, and the statute lets that relationship be established either in person OR remotely — but only through one of four named routes, one of which is an in-person examination and another the presence of a second Delaware-licensed provider with the patient at the originating site. Once the relationship is properly established, later treatment of the same patient by the same provider need not satisfy those limits again. Absent a proper relationship, issuing a prescription solely in response to an internet questionnaire, an internet consult or a telephone consult is prohibited. (24 Del. C. §6003(a); verified 2026-09-03) This is regulatory monitoring, not legal advice.

Question 9

Is an exam required before a patient can be treated in District of Columbia?

Accepted Answer

The District permits the practitioner-patient relationship itself to be established through telehealth, but ties it to the standard of care and the practitioner’s competence and scope — and expressly reserves to the Mayor the power to add requirements for specific health professions, INCLUDING an initial in-person physical examination. (D.C. Code §3-1201.05(b); verified 2026-09-03) This is regulatory monitoring, not legal advice.

Question 10

Is an exam required before a patient can be treated in Florida?

Accepted Answer

Florida has no statute literally titled “good-faith exam.” The requirement is built from prescribing-practice and standard-of-care law. (Fla. Stat. §458.331(1)(q); verified 2026-09-01) This is regulatory monitoring, not legal advice.

Question 11

Is an exam required before a patient can be treated in Georgia?

Accepted Answer

Where an ASSISTANT LASER PRACTITIONER treats the patient, Georgia requires a prior examination by a consulting physician, a PA-cosmetic laser practitioner or an APRN-cosmetic laser practitioner — and then names the exception explicitly: HAIR REMOVAL and pulsed light treatments are carved out of both the examination and the on-site supervision requirement. (Ga. Comp. R. & Regs. 360-35-.05(1)(b); verified 2026-08-17) This is regulatory monitoring, not legal advice.

Question 12

Is an exam required before a patient can be treated in Hawaii?

Accepted Answer

THE SECTIONS CITED HERE GOVERN THE PRE-TREATMENT ENCOUNTER THROUGH HAWAII’S TELEHEALTH STATUTE. Telehealth services must include a documented patient evaluation, including a history and a discussion of physical symptoms adequate to establish a diagnosis and to identify underlying conditions or contraindications to the treatment recommended. Treatment recommendations made by telehealth, including an electronic prescription, are held to the same standards as traditional physician-patient settings, and a prescription issued on an online questionnaire alone is not treatment and is not an acceptable standard of care. A physician-patient relationship may be established through a telehealth interaction by a physician licensed in Hawaii, and once established, telehealth may be used for any authorized purpose. Telehealth is defined by its modalities and excludes standard telephone, facsimile, or e-mail contact except through an interactive telecommunications system. The pharmacy act defines the practice of pharmacy to include the compounding, dispensing, and labeling of drugs, and defines a prescription as a practitioner’s order for the compounding or dispensing of drugs; neither cited pharmacy definition names a drug or mentions office stock. (Haw. Rev. Stat. § 453-1.3(e)-(f); verified 2026-09-08) This is regulatory monitoring, not legal advice.

Question 13

Is an exam required before a patient can be treated in Idaho?

Accepted Answer

Idaho’s Virtual Care Access Act permits virtual care where a provider-patient relationship already exists, where the patient has that relationship with another provider in the same provider group, where the provider is covering calls for a provider who has it, or where the provider is performing activities set out in §54-1733(3). The relationship itself MAY be established by use of virtual care technologies — but the statute attaches a condition rather than a technology list: the applicable IDAHO COMMUNITY STANDARD OF CARE must be satisfied. These claims survey section 54-5705; requirements imposed elsewhere in the Act or by board rule are not surveyed here. (Idaho Code §54-5705; verified 2026-09-03) This is regulatory monitoring, not legal advice.

Question 14

Is an exam required before a patient can be treated in Illinois?

Accepted Answer

The physician has to examine the patient and set a course of treatment before any laser procedure — with one carve-out, new in 2025, letting a non-ablative laser proceed on an APRN examination and a physician reachable by phone. ⚠️ THE CARVE-OUT CARRIES FOUR CONDITIONS, and dropping any one of them puts the procedure back under the general rule. (68 Ill. Adm. Code 1285.336(b); verified 2026-08-17) This is regulatory monitoring, not legal advice.

Question 15

Is an exam required before a patient can be treated in Indiana?

Accepted Answer

Indiana states the prescribing condition directly: a prescriber may issue a prescription without a prior in-person examination only where the STANDARD OF CARE is met, the prescriber is acting within scope, and a VALID PROVIDER-PATIENT RELATIONSHIP exists. (Ind. Code §25-1-9.5-7, §25-1-9.5-8; verified 2026-07-26) This is regulatory monitoring, not legal advice.

Question 16

Is an exam required before a patient can be treated in Iowa?

Accepted Answer

IOWA PUTS THE CONSENT AND THE RECORD ON THE MEDICAL DIRECTOR AND NAMES WHO MAY DO THE ASSESSMENT. The director must ensure that each patient gives appropriate informed consent for every medical aesthetic service, performed by whoever performs it, and that the consent is timely documented in the medical record, and that accurate and timely medical records are kept for each delegated service. On the nursing side an ARNP may assess health status, obtain a relevant health and medical history, perform physical examinations, formulate a differential diagnosis and develop a treatment plan. Where the encounter is remote, Iowa defines TELEMEDICINE to exclude audio-only telephone, email, fax and post. (Iowa Admin. Code r. 481—655.6(5)(j) (Supervision — informed consent); verified 2026-09-04) This is regulatory monitoring, not legal advice.

Question 17

Is an exam required before a patient can be treated in Kansas?

Accepted Answer

Kansas permits telemedicine to establish the relationship, and then holds it to the in-person standard. The Act says in one line that telemedicine MAY be used to establish a valid provider-patient relationship, and in the next that the same standards of practice and conduct that apply to healthcare services delivered in person also apply to services delivered by telemedicine — as do the same HIPAA patient privacy and confidentiality requirements. It adds two follow-through duties: the provider must give the patient guidance on appropriate follow-up care, and where the patient consents and has a primary care or other treating physician, must send that physician a report of the treatment and services rendered WITHIN THREE BUSINESS DAYS. Prescribing, dispensing, administering or distributing a prescription drug in an improper or inappropriate manner, or for other than a valid medical purpose, or not in the course of the licensee’s professional practice, is unprofessional conduct. (Kan. Stat. Ann. §40-2,212(b); verified 2026-09-03) This is regulatory monitoring, not legal advice.

Question 18

Is an exam required before a patient can be treated in Kentucky?

Accepted Answer

KENTUCKY WRITES THE ONLINE-PRESCRIBING RULE AS THREE NAMED STEPS, AND MISSING ANY OF THEM IS DISHONORABLE CONDUCT. Separately, a treating physician who provides or facilitates telehealth must ensure the patient's INFORMED CONSENT is obtained before services are provided through telehealth, and that confidentiality of the patient's medical information is maintained; the board is directed to promulgate regulations as necessary to prevent abuse and fraud through telehealth services and to PREVENT FEE-SPLITTING through them. Prescribing or dispensing medication IN RESPONSE TO ANY COMMUNICATION TRANSMITTED OR RECEIVED BY COMPUTER OR OTHER ELECTRONIC MEANS is dishonorable, unethical or unprofessional conduct where the licensee fails to take three actions to establish and maintain a proper physician-patient relationship: VERIFICATION that the person requesting medication is in fact who the patient claims to be; ESTABLISHMENT OF A DOCUMENTED DIAGNOSIS through the use of accepted medical practices; and MAINTENANCE OF A CURRENT MEDICAL RECORD. The same section reaches prescribing with the intent or knowledge that a medication will be used other than medicinally or for an accepted therapeutic purpose, and prescribing in amounts the licensee knows or has reason to know are excessive under accepted and prevailing medical practice standards. (Ky. Rev. Stat. §311.5975(1); verified 2026-09-03) This is regulatory monitoring, not legal advice.

Question 19

Is an exam required before a patient can be treated in Louisiana?

Accepted Answer

THESE CLAIMS SURVEY THE MEDICAL PRACTICE ACT, NOT A TELEHEALTH STATUTE, AND SHOULD BE READ THAT WAY. Louisiana's licensing section itself points elsewhere for remote care — it requires a license to practice medicine “except as provided in the Louisiana Telehealth Access Act, R.S. 40:1223.1 et seq.” — and that Act is NOT surveyed by these claims. What is on record here is the standard the treatment must meet however it is delivered: prescribing, dispensing or administering legally controlled substances or any dependency-inducing medication WITHOUT LEGITIMATE MEDICAL JUSTIFICATION, or in other than a legal or legitimate manner, is a cause for discipline; so is medical incompetency, which the statute defines to include continuing or recurring medical practice that FAILS TO SATISFY THE PREVAILING AND USUALLY ACCEPTED STANDARDS of medical practice in this state; and so is abandonment of a patient. Confirm the telehealth intake requirements against R.S. 40:1223.1 et seq. with the board or counsel. (La. Rev. Stat. §37:1285(A)(6); verified 2026-09-03) This is regulatory monitoring, not legal advice.

Question 20

Is an exam required before a patient can be treated in Maine?

Accepted Answer

Maine’s telehealth subchapter permits a licensee of the medical chapter to provide telehealth services so long as the licensee acts within the scope of the license, within the subchapter’s own requirements and restrictions, and in accordance with standards of practice — and it carries the rest of the licensee’s obligations across unchanged: all laws and rules on professional responsibility, unprofessional conduct and generally accepted standards of practice apply while providing telehealth, as do state and federal confidentiality and privacy laws. The subchapter defines telehealth services broadly enough to include asynchronous encounters and store-and-forward transfers, not only real-time video. These claims survey subchapter 4 of chapter 48; requirements imposed elsewhere in Maine law or by board rule are not surveyed here. (32 M.R.S. §3300-BB; verified 2026-09-03) This is regulatory monitoring, not legal advice.

Question 21

Is an exam required before a patient can be treated in Maryland?

Accepted Answer

Maryland requires a clinical patient evaluation appropriate to the patient and the presenting condition BEFORE treatment is provided or a prescription issued through telehealth, and requires referral to in-person care where that is clinically appropriate. (Md. Code Regs. 10.32.05.05(A) (Patient Evaluation); verified 2026-09-03) This is regulatory monitoring, not legal advice.

Question 22

Is an exam required before a patient can be treated in Massachusetts?

Accepted Answer

CHAPTER 112 sets no pre-treatment examination rule — the chapter was surveyed in full and contains none. ⚠️ That is a statement about chapter 112, not about Massachusetts: the Board’s own regulations at 243 CMR are published on a host we do not fetch, so no absence is claimed for them. What chapter 112 does do is define telehealth expressly widely, leaving the clinical standard to the Board. (Mass. Gen. Laws ch. 112, § 5O(a); verified 2026-09-01) This is regulatory monitoring, not legal advice.

Question 23

Is an exam required before a patient can be treated in Michigan?

Accepted Answer

⚠️ MICHIGAN SPLITS BY DRUG SCHEDULE, NOT BY PROCEDURE. PART 161 of the Public Health Code was surveyed via its section index and imposes no pre-treatment examination requirement for cosmetic injectables. But § 333.7303a(2) bars prescribing any SCHEDULE 2 TO 5 CONTROLLED SUBSTANCE outside a BONA FIDE PRESCRIBER-PATIENT RELATIONSHIP, with a follow-up care duty attached. Testosterone is Schedule III, so a hormone-therapy practice is inside that rule. (Mich. Comp. Laws pt. 161 — section index (surveyed in full); verified 2026-09-02) This is regulatory monitoring, not legal advice.

Question 24

Is an exam required before a patient can be treated in Minnesota?

Accepted Answer

⚠️ MINNESOTA’S DOCUMENTED-EXAMINATION DUTY SITS IN THE DRUG CHAPTER, NOT THE MEDICAL PRACTICE ACT, AND IS SCOPED BY DRUG CLASS. § 151.37 subd. 2(d) makes a prescription INVALID — for a closed list of drug classes — without a documented evaluation INCLUDING AN EXAMINATION. Testosterone is a Schedule III controlled substance, so a hormone-therapy med spa is inside that list; botulinum toxin, fillers and semaglutide are not on it. (Minn. Stat. § 151.37, subd. 2(d); verified 2026-09-02) This is regulatory monitoring, not legal advice.

Question 25

Is an exam required before a patient can be treated in Mississippi?

Accepted Answer

THE SECTIONS CITED HERE GOVERN THE PRE-TREATMENT ENCOUNTER THROUGH THE MEDICAL BOARD’S TELEMEDICINE AND INTERNET-PRESCRIBING RULES AND THE NURSING BOARD’S PRESCRIBING RULE. A valid physician-patient relationship for telemedicine requires verifying the patient’s identity, an appropriate history and physical examination meeting the standard of care, a diagnosis established through accepted practices, a discussion of the diagnosis and treatment options to obtain informed consent, follow-up care, and a complete medical record. Providers using telemedicine must examine before diagnosing and treating, and the examination need not be in person if the technology gives the physician the same information as a face-to-face exam; a simple questionnaire without an appropriate exam violates the rule. The internet-prescribing rule says prescribing to a person the physician has never met, based solely on answers to a set of questions, fails an acceptable standard of care. An advanced practice registered nurse may not prescribe any medication without a good faith agreement subsequent to examination and medical indication. Telemedicine is the practice of medicine through HIPAA-compliant telecommunication systems capable of replicating an in-person encounter, and practicing it into Mississippi from out of state requires a Mississippi license. The pharmacy act defines the practice of pharmacy to include compounding and dispensing; that definition names no drug and says nothing about office stock. (Miss. Admin. Code Title 30, Part 2635, Rule 5.4; verified 2026-09-08) This is regulatory monitoring, not legal advice.

Question 26

Is an exam required before a patient can be treated in Missouri?

Accepted Answer

MISSOURI ANSWERS THE ONLINE-INTAKE QUESTION DIRECTLY, AND THE ANSWER IS CONDITIONAL. A physician using telemedicine must ensure a properly established physician-patient relationship exists, and the statute names the three ways it may be established: an in-person encounter through a medical evaluation and physical examination; consultation with another physician who has an established relationship with the patient and an agreement to participate in that patient’s care; or a telemedicine encounter, IF the standard of care does not require an in-person encounter. To establish the relationship through telemedicine the technology must be sufficient to reach an informed diagnosis as though the evaluation, and any physical examination the standard of care requires, had been performed in person. A questionnaire — internet or telephone — must be reviewed by the treating health care professional and must itself carry information sufficient to serve as though the medical evaluation had been performed in person; otherwise the statute says in terms that it DOES NOT constitute an acceptable medical evaluation and examination for providing treatment by telehealth. Before prescribing through telemedicine or the internet, the physician must obtain a reliable medical history and, if the standard of care requires, perform a physical examination adequate to establish the diagnosis and identify underlying conditions or contraindications. (Mo. Rev. Stat. §191.1146.1; verified 2026-09-03) This is regulatory monitoring, not legal advice.

Question 27

Is an exam required before a patient can be treated in Montana?

Accepted Answer

THE SECTIONS CITED HERE GOVERN THE PRE-TREATMENT ENCOUNTER THROUGH A TELEMEDICINE DEFINITION, A TELEHEALTH AUTHORIZATION, AND A BOARD RULE THAT SAYS WHEN A PROVIDER-PATIENT RELATIONSHIP EXISTS. The Code defines telemedicine as the practice of medicine by interactive electronic communications, information technology, or audio-only conversation between a licensee and a patient in different locations, and permits a person licensed under Title 37 to provide health care to do so by telehealth when that is appropriate, meets the standard of care, and complies with the licensing board’s rules. The Board of Medical Examiners’ telemedicine rule then sets the terms of that relationship: treatment occurs where the patient is, the same standard of care applies as in person, and a provider-patient relationship may be established by an in-person interview and examination when the standard of care requires one, by consultation with another provider who has a documented relationship with the patient, or through telemedicine if the standard of care does not require an in-person encounter. Before treating, prescribing, or delegating, the licensee must establish that relationship and obtain a medical history sufficient for diagnosis and treatment, and may delegate the patient’s care only to providers the licensee knows to be qualified, who have their own relationship with the patient, or who can reach the licensee for consultation. The pharmacy act defines compounding and says it does not prevent a medical practitioner from compounding or using drugs in the practitioner’s practice or furnishing drugs to a patient; neither cited pharmacy section names a drug or mentions office stock. (Mont. Code Ann. § 37-3-102(14)(a)-(b); verified 2026-09-08) This is regulatory monitoring, not legal advice.

Question 28

Is an exam required before a patient can be treated in Nebraska?

Accepted Answer

What these claims establish in Nebraska is a therapeutic-purpose and record-keeping standard rather than a pre-treatment examination requirement. Prescribing, administering, distributing, dispensing, giving or selling a controlled or dangerous drug for other than a medically accepted THERAPEUTIC PURPOSE is unprofessional conduct, as is prescribing a controlled substance to oneself or to close family outside a medical emergency, and as is failing to keep and maintain adequate records of treatment or service. (Neb. Rev. Stat. §38-179(11); verified 2026-09-03) This is regulatory monitoring, not legal advice.

Question 29

Is an exam required before a patient can be treated in Nevada?

Accepted Answer

Nevada regulates how the patient relationship itself may be formed. A provider may establish a relationship using telehealth only when it is clinically appropriate to do so, must hold a valid Nevada license before directing care or prescribing remotely, and gains no additional scope of practice by working this way — telehealth expressly may not be read to modify, expand or alter a provider’s scope, or to authorize a setting not otherwise authorized by law. (Nev. Rev. Stat. §629.515(4); verified 2026-09-03) This is regulatory monitoring, not legal advice.

Question 30

Is an exam required before a patient can be treated in New Hampshire?

Accepted Answer

New Hampshire defines the physician-patient relationship itself: it requires an in-person exam OR an exam using telemedicine. Where the telemedicine route is used the statute attaches conditions — verifying the identity of the patient receiving services through telemedicine, disclosing the physician’s name, contact information and license type, obtaining consent where a parent or guardian’s consent is required for telemedicine, and meeting the standard of care. Prescribing to someone with whom no physician-patient relationship exists is unprofessional conduct. (N.H. Rev. Stat. §329:1-c (Physician-Patient Relationship); verified 2026-09-03) This is regulatory monitoring, not legal advice.

Question 31

Is an exam required before a patient can be treated in New Jersey?

Accepted Answer

WHERE A MODALITY IS ADMINISTERED BY SOMEONE ELSE, New Jersey stacks three duties on the physician: examine the patient before it is applied, see them again before every subsequent scheduled application, and remain ON THE PREMISES throughout. A course of treatment does not buy a standing clearance. (N.J.A.C. 13:35-6.14(e)1; verified 2026-08-17) This is regulatory monitoring, not legal advice.

Question 32

Is an exam required before a patient can be treated in New Mexico?

Accepted Answer

NEW MEXICO PUTS THE EXAM BEYOND DELEGATION IN SO MANY WORDS. Before any aesthetic healthcare procedure, an APRN or other licensed independent practitioner must conduct a FACE-TO-FACE assessment, determine a diagnosis and prescribe a treatment plan — and "may never delegate the examination, diagnosis, or treatment plan". The initial examination must review the health history and physically examine the treatment sites. For continuing patients the face-to-face is required at least once every twelve months, and sooner on any change in health status or treatment plan. TELEMEDICINE IS PERMITTED for that examination, provided the video quality does not adversely affect the assessment or diagnosis. Where a medical assistant runs the device, the SUPERVISING PHYSICIAN must personally supply the history, physical examination, diagnosis, treatment protocol and record before treatment begins. (16.12.14.10(B) NMAC (Patient care); verified 2026-09-04) This is regulatory monitoring, not legal advice.

Question 33

Is an exam required before a patient can be treated in New York?

Accepted Answer

New York builds the requirement rather than naming it. PRESCRIBING sits inside the statutory definition of the practice of medicine, and the enforcement route is the misconduct grounds of practicing with NEGLIGENCE ON MORE THAN ONE OCCASION or INCOMPETENCE ON MORE THAN ONE OCCASION. (N.Y. Educ. Law §6521; verified 2026-08-17) This is regulatory monitoring, not legal advice.

Question 34

Is an exam required before a patient can be treated in North Carolina?

Accepted Answer

Both boards land in the same place from different directions: someone with prescriptive authority has to evaluate the patient and order the treatment before a nurse touches them, and for LASER HAIR OR TATTOO REMOVAL a physician, physician assistant or nurse practitioner must examine the patient before the first treatment. (NC Board of Nursing, Cosmetic/Aesthetic Dermatological Procedures Position Statement (rev. 9/2022); verified 2026-08-17) This is regulatory monitoring, not legal advice.

Question 35

Is an exam required before a patient can be treated in North Dakota?

Accepted Answer

NORTH DAKOTA WROTE ITS PRE-TREATMENT RULE INSIDE A TELEMEDICINE SECTION, AND THE SCOPE OF EACH PART MATTERS. Section 43-17-44 opens by holding a licensee to the same standard of care and the same ethical standards whether the practice is traditional in-person medicine or telemedicine. The requirements that follow are stated in the context of telemedicine: a BONA FIDE RELATIONSHIP with the patient before any diagnosis or treatment, and — before initially diagnosing or treating a patient for a specific illness or condition — an EXAMINATION OR EVALUATION MUST BE PERFORMED. A licensee PRACTICING TELEMEDICINE must also verify the patient’s identity and let the patient verify that licensee’s own identity and licensure status. Prescribing follows the examination: 43-17-45 permits it where the telemedicine examination met the chapter’s requirements. (N.D.C.C. § 43-17-44 (Standard of care — telemedicine and in-person alike); verified 2026-09-05) This is regulatory monitoring, not legal advice.

Question 36

Is an exam required before a patient can be treated in Ohio?

Accepted Answer

Ohio’s examination rule in this chapter is delegation-specific rather than general: for photodynamic therapy and for phototherapy for psoriasis, the physician must have seen and evaluated the patient before delegating, and on a report of a clinically significant side effect in those same delegated treatments the physician must see and personally evaluate the patient. What Ohio says without qualification is about the remote visit — the standard of care for a telehealth visit is the same as for an in-person visit, and telephone calls qualify only when every element of a bona fide health care visit meeting that standard is performed. (Ohio Admin. Code 4731-18-04; verified 2026-08-17) This is regulatory monitoring, not legal advice.

Question 37

Is an exam required before a patient can be treated in Oklahoma?

Accepted Answer

Oklahoma states its pre-treatment rule as a disciplinary ground rather than a standalone requirement, and it is easy to miss because it does not use the words most states use. § 509 makes it unprofessional conduct to prescribe or administer a drug or treatment WITHOUT SUFFICIENT EXAMINATION AND THE ESTABLISHMENT OF A VALID PHYSICIAN-PATIENT RELATIONSHIP. That is the good-faith-examination rule; it is not titled one. (Okla. Stat. tit. 59, § 509 (Examination and a valid relationship before prescribing); verified 2026-09-05) This is regulatory monitoring, not legal advice.

Question 38

Is an exam required before a patient can be treated in Oregon?

Accepted Answer

Oregon permits the provider-patient relationship itself to be established by telemedicine. A physician or physician associate may use telemedicine to practice medicine and provide health care services, including establishing the relationship, diagnosing or treating a condition, and prescribing. (Or. Rev. Stat. §677.494(2); verified 2026-09-03) This is regulatory monitoring, not legal advice.

Question 39

Is an exam required before a patient can be treated in Pennsylvania?

Accepted Answer

Pennsylvania approaches the pre-treatment question from the DELEGATION side: the physician has to make a patient-specific judgment before anyone else touches the patient, and some services cannot be handed over at all. (49 Pa. Code §18.402(b); verified 2026-08-17) This is regulatory monitoring, not legal advice.

Question 40

Is an exam required before a patient can be treated in Rhode Island?

Accepted Answer

THESE CLAIMS SURVEY THE UNPROFESSIONAL CONDUCT SECTION OF THE MEDICAL PRACTICE CHAPTER, NOT A TELEHEALTH-SPECIFIC STATUTE, AND SHOULD BE READ THAT WAY. What they establish is the standard the treatment itself must meet however it is delivered. Incompetent, negligent or willful misconduct in the practice of medicine is unprofessional conduct, and the statute says in terms that this INCLUDES the rendering of medically unnecessary services and any departure from, or failure to conform to, the minimal standards of acceptable and prevailing medical practice in the licensee’s area of expertise as determined by the board — and that the board need NOT establish actual injury to the patient to find it. Offering, undertaking or agreeing to cure or treat disease by a secret method, procedure, treatment or medicine is separately unprofessional conduct, as is making willful misrepresentations in treatments. THE REMOTE QUESTION IS NOW SURVEYED, AND IT IS ANSWERED IN THE BOARD’S OWN RULE RATHER THAN THE STATUTE. 216-RICR-40-05-1 § 1.5.9(H)(2) holds an online treatment or consultation recommendation — a prescription issued electronically included — to the same standards of appropriate practice as a face-to-face one, treats a prescription based solely on an online questionnaire without an appropriate evaluation as unprofessional conduct, and says an asynchronous evaluation without a contemporaneous real-time interactive exchange is not appropriate. What these claims do NOT survey is any intake requirement specific to cosmetic medicine; confirm that with the board or counsel. (R.I. Gen. Laws §5-37-5.1(19); verified 2026-09-03) This is regulatory monitoring, not legal advice.

Question 41

Is an exam required before a patient can be treated in South Carolina?

Accepted Answer

South Carolina does not lower the standard for remote care: a licensee practicing medicine by telemedicine must meet the SAME standard of care as in-person medical care, failing which is expressly designated unprofessional conduct, and the licensee must hold a South Carolina medical license. The record and prescribing discipline sits alongside it — failing to prepare or maintain an adequate patient record of the care provided, and signing a blank prescription form, are each grounds for disciplinary action. (S.C. Code §40-47-110(B)(17); verified 2026-09-03) This is regulatory monitoring, not legal advice.

Question 42

Is an exam required before a patient can be treated in South Dakota?

Accepted Answer

South Dakota's telehealth chapter states WHO may treat. Any health care professional treating a patient in the state through telehealth shall be FULLY LICENSED to practice in the state — or employed by one of the named licensed or accredited facilities — AND subject to any rule adopted by the applicable South Dakota licensing body. Telehealth itself is defined broadly: the use of secure electronic information, imaging and communication technologies by a health care professional to deliver health care services to a patient, INCLUDING interactive audio-video, interactive audio with store and forward, store-and-forward technology, and remote patient monitoring. Because the operative requirements are pushed to the licensing body's rules, these claims do not themselves fix an examination requirement; what they do fix is the standard the board measures against — professional incompetence is a DEVIATION FROM THE STATEWIDE STANDARD OF COMPETENCE, being the minimum degree of skill and knowledge necessary to perform the characteristic tasks of a physician in at least a reasonably effective way. (S.D. Codified Laws §34-52-2; verified 2026-09-03) This is regulatory monitoring, not legal advice.

Question 43

Is an exam required before a patient can be treated in Tennessee?

Accepted Answer

⚠️ TENNESSEE HAS ONE OF THE STRONGEST EXAMINATION RULES IN THIS CORPUS, AND IT IS NOT OPTIONAL. Rule 0880-02-.14(7) makes it a PRIMA FACIE VIOLATION to prescribe or dispense ANY DRUG without a documented history, examination, diagnosis, discussed plan and follow-up — and says outright that A QUESTIONNAIRE IS NOT AN EXAMINATION. The telemedicine rules then disclaim any effect on that duty rather than relaxing it. (Tenn. Comp. R. & Regs. 0880-02-.16 (scope); verified 2026-09-02) This is regulatory monitoring, not legal advice.

Question 44

Is an exam required before a patient can be treated in Texas?

Accepted Answer

Before a delegated cosmetic act Texas requires a PRACTITIONER-PATIENT RELATIONSHIP to be established — by a physician, or by a PA or APRN acting under the physician’s delegation — and an adequate medical RECORD to be maintained. A physician, PA or APRN must be onsite or immediately available, and at least one person trained in basic life support must be present. (22 TAC §169.26; verified 2026-07-26) This is regulatory monitoring, not legal advice.

Question 45

Is an exam required before a patient can be treated in Utah?

Accepted Answer

UTAH REQUIRES THE EVALUATION BY STATUTE AND NAMES WHO MAY DO IT. Before a treatment protocol or series of treatments begins for a NONABLATIVE cosmetic medical procedure, a physician, a nurse practitioner or a physician assistant — each holding an unrestricted license — must develop the treatment plan for that procedure AND conduct an evaluation of the patient, either in person or by a LIVE TELEMEDICINE VISIT. Utah reinforces it from the other end: a medical assistant UNDER THE INDIRECT SUPERVISION OF A PHYSICIAN may not diagnose and may not establish a treatment plan. The statute also defines DIRECT cosmetic medical procedure supervision as the supervisor being present and available for face-to-face communication when and where the procedure is performed. (Utah Code § 58-1-506(3)(a) (Supervision of cosmetic medical procedures); verified 2026-09-04) This is regulatory monitoring, not legal advice.

Question 46

Is an exam required before a patient can be treated in Vermont?

Accepted Answer

Vermont requires an appropriate examination of the patient — in person, through telemedicine, or by instrumentation and diagnostic equipment through which images and records may be transmitted — before a licensed health care provider prescribes, dispenses or administers drugs, and holds treatment recommendations made electronically to the same standards of appropriate practice as those in traditional provider-patient settings. The rest of what these claims establish is narrower: signing a blank or undated prescription form is unprofessional conduct, as is prescribing, selling, administering, distributing, ordering or dispensing a controlled substance for the licensee’s own use or for an immediate family member. Separately, the Board may require a licensee to submit to a mental or physical examination and an evaluation of medical knowledge and skill where it has a reasonable basis to doubt competence. (Vt. Stat. tit. 26, §1354(a)(38); verified 2026-09-03) This is regulatory monitoring, not legal advice.

Question 47

Is an exam required before a patient can be treated in Virginia?

Accepted Answer

⚠️ VIRGINIA’S EXAMINATION DUTY IS IN THE PHARMACY CHAPTER, NOT THE BOARD OF MEDICINE REGULATIONS. § 54.1-3303 lets a prescription issue ONLY to a patient with whom the practitioner has a BONA FIDE PRACTITIONER-PATIENT RELATIONSHIP, and defines that by four elements — history, risk disclosure, AN APPROPRIATE EXAMINATION, and follow-up. Botulinum toxin and fillers are prescription drugs, so a Virginia med spa is inside it. The Board of Medicine regulations then add a separate duty about WHO may be handed the patient. (18 Va. Admin. Code § 85-20-29(A)(1); verified 2026-09-02) This is regulatory monitoring, not legal advice.

Question 48

Is an exam required before a patient can be treated in Washington?

Accepted Answer

Washington writes out SEVEN things a physician must do before authorizing a nonsurgical medical cosmetic procedure, rather than naming a “good-faith exam”. The same seven attach whether the procedure is an injection or an energy device. (Wash. Admin. Code 246-919-606(5); verified 2026-09-02) This is regulatory monitoring, not legal advice.

Question 49

Is an exam required before a patient can be treated in West Virginia?

Accepted Answer

West Virginia legislates the telemedicine encounter in detail, and the detail is restrictive at the front end. A physician-patient relationship MAY NOT be established through text-based communications such as e-mail, Internet questionnaires, text-based messaging or other written forms of communication. Where no relationship existed beforehand, or where services are rendered solely by telemedicine, it may be established only through interactive audio using store and forward technology, real-time videoconferencing or similar secure video services at the initial encounter — or through real-time audio-only calls, with the statute stating that audio-visual communication is preferable if available or possible. Once the relationship exists, whether in person or by those routes, the physician may use any telemedicine technology that meets the standard of care and suits the presentation. The Act also fixes jurisdiction: the practice of medicine occurs where the PATIENT is located when the technology is used. (W. Va. Code §30-3-13a(c)(1); verified 2026-09-03) This is regulatory monitoring, not legal advice.

Question 50

Is an exam required before a patient can be treated in Wisconsin?

Accepted Answer

Wisconsin imposes an INFORMED CONSENT duty by statute and measures it against a reasonable-physician standard — and its telemedicine rules refuse to lower any of it. (Wis. Stat. § 448.30; verified 2026-09-02) This is regulatory monitoring, not legal advice.

Question 51

Is an exam required before a patient can be treated in Wyoming?

Accepted Answer

Wyoming defines both halves of the question in the Medical Practice Act. A “physician-patient relationship” means a relationship between a licensee and any person FORMED FOR THE PURPOSE of the licensee providing medical diagnosis or treatment, whether or not for compensation — a purpose test, with no in-person requirement stated in the definition. “Telemedicine” means the practice of medicine by electronic communication or other means from a physician in one location to a patient in another, with or without an intervening health care provider. The licensing statute then says a board MAY adopt rules allowing telemedicine and telehealth within the applicable profession, with the term to be defined inside each promulgated rule. Whether any examination or intake requirement applies to a Wyoming med spa, in statute or in board rules, is NOT surveyed by these claims; confirm it with the board or counsel. What the statute does supply is the standard: making false or misleading statements regarding the licensee's skill or the efficacy or value of a treatment or remedy is a ground for discipline. (Wyo. Stat. Ann. §33-26-102(a)(xx); verified 2026-09-03) This is regulatory monitoring, not legal advice.

State	What its rule says	Cited to
Alabama	The cited rules do not settle this — they require the physician's written protocol to contain criteria for screening whether a patient is appropriate for non-ablative treatment, but they do not mandate a separate physician exam before treatment.	Ala. Admin. Code r. 540-X-11-.05(3) (Written protocols — patient selection) Sep 4, 2026
Alaska	AS 08.64.364 reaches the pre-treatment examination from the opposite direction to most states: rather than requiring an exam, it tells the Medical Board when it may NOT discipline a physician or physician assistant for prescribing without a physical examination.	AS 08.64.364(a) (Prescription of drugs without physical examination) Sep 5, 2026
Arizona	Yes — treatment needs a valid order from an authorized prescriber acting within the standard of care, but the assessment may be done by telehealth with documented informed consent; no prior in-person exam can be required for Botox or fillers.	A.R.S. §32-1401(27) Jul 26, 2026
Arkansas	Yes — for laser treatment the physician must personally diagnose the patient and prescribe the procedure, and before any telemedicine visit a patient/provider relationship must be established; an online medical history form alone does not establish it.	17 CAR § 140-3201(a) (Telemedicine — patient/provider relationship) Sep 4, 2026
California	Yes — Botox or fillers can't be prescribed or furnished without an appropriate prior exam and a medical indication. The exam need not be synchronous: telehealth, including a self-screening tool or questionnaire, counts if the standard of care is met.	Cal. Bus. & Prof. Code §2242(a) Jul 26, 2026
Colorado	Not directly — Article 240 requires no history, exam, diagnosis or treatment plan before treating or prescribing; care is still judged against generally accepted standards of medical practice, and the Board's 3 CCR 713 rules were not surveyed.	Colo. Rev. Stat. art. 240 of tit. 12, surveyed in full; the examination provisions are at § 12-240-125 Sep 2, 2026
Connecticut	Yes — at a medical spa, a physician, physician assistant, or APRN employed by or under contract with the spa must perform an initial in-person physical assessment of each person before any cosmetic medical procedure is performed.	Conn. Gen. Stat. §19a-903c(c) Sep 3, 2026
Delaware	Delaware puts its telehealth rule in a chapter of its own.	24 Del. C. §6003(a) Sep 3, 2026
District of Columbia	The cited rules do not settle this — they establish only that a practitioner-patient relationship may be formed via telehealth where the standard of care and the practitioner's scope allow, and that the Mayor may by rulemaking add an initial in-person exam.	D.C. Code §3-1201.05(b) Sep 3, 2026
Florida	Not directly — for injectables Florida names no good-faith exam and no examiner; what it requires is that prescribing or administering a legend drug sit inside the physician's own course of professional practice, which the Board judges after the fact.	Fla. Stat. §458.331(1)(q) Sep 1, 2026
Georgia	Yes — a patient treated by an assistant laser practitioner must be examined beforehand by the consulting physician, or by a PA or APRN who is a licensed cosmetic laser practitioner; laser hair removal and pulsed light treatments are exempt from that exam.	Ga. Comp. R. & Regs. 360-35-.05(1)(b) Aug 17, 2026
Hawaii	Yes for telehealth — the visit must include a documented evaluation with history and symptoms adequate to diagnose and flag contraindications, and a questionnaire alone doesn't count; a Hawaii-licensed physician may form the relationship by telehealth.	Haw. Rev. Stat. § 453-1.3(e)-(f) Sep 8, 2026
Idaho	Not directly — the cited rules require an established provider-patient relationship before virtual care, not a specific exam, and that relationship may be formed using virtual care technologies so long as Idaho's community standard of care is met.	Idaho Code §54-5705 Sep 3, 2026
Illinois	Yes — a physician must examine the patient and set a course of treatment before any laser procedure; no repeat exam per procedure under an established plan, and since 2025 an APRN may do that exam for delegated non-ablative lasers if four conditions are met.	68 Ill. Adm. Code 1285.336(b) Aug 17, 2026
Indiana	Not always — a prescriber may skip the prior in-person exam only if the standard of care is met, the prescription is within their scope, and a valid provider-patient relationship exists: ID/location check, consent, history enough to diagnose, risk discussion.	Ind. Code §25-1-9.5-7, §25-1-9.5-8 Jul 26, 2026
Iowa	The cited rules do not settle this — they require appropriate informed consent from each patient for medical aesthetic services, timely documented in the medical record, but set no separate pre-treatment or good-faith exam requirement.	Iowa Admin. Code r. 481—655.6(5)(j) (Supervision — informed consent) Sep 4, 2026
Kansas	Kansas lets telemedicine establish the provider-patient relationship, held to the same standards as in-person care. With the patient's consent, a report goes to their treating physician within three business days.	Kan. Stat. Ann. §40-2,212(b) Sep 3, 2026
Kentucky	The cited rules do not settle this — none states a general pre-treatment exam; telehealth requires informed consent first, and prescribing by electronic communication requires identity verification, a documented diagnosis, and a current medical record.	Ky. Rev. Stat. §311.5975(1) Sep 3, 2026
Louisiana	The cited rules do not settle this — none require a pre-treatment exam; they only make prescribing or administering controlled substances without legitimate medical justification, and practice below accepted standards, grounds for board discipline.	La. Rev. Stat. §37:1285(A)(6) Sep 3, 2026
Maine	The cited rules do not settle this — none imposes an exam requirement, in person or otherwise; they only require a licensee using telehealth to stay within their license's scope and meet the same standards of practice and professional conduct as in person.	32 M.R.S. §3300-BB Sep 3, 2026
Maryland	Yes for telehealth — a clinical patient evaluation, synchronous or asynchronous and appropriate to the patient and presenting condition, must come before any treatment or prescription; the cited rules set no separate exam rule for in-person visits.	Md. Code Regs. 10.32.05.05(A) (Patient Evaluation) Sep 3, 2026
Massachusetts	The cited rules do not settle this — the statutes contain no pre-treatment exam requirement, and telehealth (including audio-only) is defined to cover evaluating, prescribing and treating; the pre-treatment standard sits in Board regulations.	Mass. Gen. Laws ch. 112, § 5O(a) Sep 1, 2026
Michigan	The cited rules do not settle this — Part 161's section index shows no pre-treatment exam rule for toxin or filler, while Schedule 2–5 prescribing does require a bona fide prescriber-patient relationship plus follow-up care or referral.	Mich. Comp. Laws pt. 161 — section index (surveyed in full) Sep 2, 2026
Minnesota	Yes for listed drugs — a prescription for a controlled substance, muscle relaxant, opioid-activity analgesic, butalbital drug or ED drug is not valid without a documented patient evaluation including an exam; botulinum toxin and fillers are off that list.	Minn. Stat. § 151.37, subd. 2(d) Sep 2, 2026
Mississippi	Yes — for telemedicine, an appropriate history and exam meeting the standard of care must precede diagnosis and treatment, and prescribing requires a prior exam; a questionnaire alone won't do. The cited rules set no separate exam rule for in-person visits.	Miss. Admin. Code Title 30, Part 2635, Rule 5.4 Sep 8, 2026
Missouri	Yes for telemedicine — before treating, the physician must establish the patient relationship, review relevant history, and perform an exam sufficient for diagnosis; an in-person physical exam is needed only where the standard of care requires it.	Mo. Rev. Stat. §191.1146.1 Sep 3, 2026
Montana	The cited rules settle this only for telemedicine — there the licensee must establish a provider-patient relationship and take a sufficient medical history before treating; an in-person exam is required only where the standard of care demands it.	Mont. Code Ann. § 37-3-102(14)(a)-(b) Sep 8, 2026
Nebraska	The cited rules do not settle this — none of them require a pre-treatment exam; they only make it unprofessional conduct to prescribe or administer a drug for other than a medically accepted therapeutic purpose, and to fail to keep adequate treatment records.	Neb. Rev. Stat. §38-179(11) Sep 3, 2026
Nevada	The cited rules do not settle this — no good-faith exam requirement appears; they only let a licensed provider establish the patient relationship by telehealth when clinically appropriate, without changing scope of practice or the standard of care.	Nev. Rev. Stat. §629.515(4) Sep 3, 2026
New Hampshire	Only for prescribing — a physician-patient relationship requires an in-person or telemedicine exam, and prescribing without one is unprofessional conduct; the cited rules set no exam requirement for treatment that involves no prescription.	N.H. Rev. Stat. §329:1-c (Physician-Patient Relationship) Sep 3, 2026
New Jersey	Yes — where a physical modality is to be administered by anyone other than the physician, the physician must first examine the patient to assess the trauma or disease, decide whether the modality will help, and weigh risks against benefits.	N.J.A.C. 13:35-6.14(e)1 Aug 17, 2026
New Mexico	Yes, for nurses in aesthetic healthcare facilities — an APRN or other licensed independent practitioner must examine the patient face-to-face (telemedicine may satisfy this), diagnose and set a treatment plan first; that can never be delegated.	16.12.14.10(B) NMAC (Patient care) Sep 4, 2026
New York	Not as an express general rule — diagnosis sits inside the practice of medicine, and a failure to evaluate is reached as negligence or incompetence on more than one occasion; only energy-device treatments carry an express assessment before, during and after.	N.Y. Educ. Law §6521 Aug 17, 2026
North Carolina	Yes — a physician, NP, PA or other prescriber must evaluate the patient and issue the order before a nurse treats, and that evaluation can't be delegated to the treating nurse. An exam is also required before a first laser hair or tattoo removal.	NC Board of Nursing, Cosmetic/Aesthetic Dermatological Procedures Position Statement (rev. 9/2022) Aug 17, 2026
North Dakota	Yes — an examination or evaluation must be performed before a licensee first diagnoses or treats a patient for a specific condition, and a bona fide patient relationship must exist first; the same standard applies whether in person or by telemedicine.	N.D.C.C. § 43-17-44 (Standard of care — telemedicine and in-person alike) Sep 5, 2026
Ohio	Yes — the physician must see and evaluate the patient to confirm the treatment is appropriate before any delegated photodynamic therapy or psoriasis phototherapy, and before the first application in delegated laser hair removal.	Ohio Admin. Code 4731-18-04 Aug 17, 2026
Oklahoma	Yes — prescribing or administering any drug or treatment without a sufficient examination and an established physician-patient relationship is unprofessional conduct; that relationship may be established by telemedicine, except for opiates or benzodiazepines.	Okla. Stat. tit. 59, § 509 (Examination and a valid relationship before prescribing) Sep 5, 2026
Oregon	Not in person — a physician or physician associate may establish the provider-patient relationship and diagnose, treat, or prescribe by telemedicine, synchronous or asynchronous. The cited rules set no separate pre-treatment exam requirement.	Or. Rev. Stat. §677.494(2) Sep 3, 2026
Pennsylvania	The cited rules do not settle this — no cited rule requires a pre-treatment exam, but before any delegated service the physician must find that this specific patient faces no undue risk, and may not delegate work needing physician-level skill.	49 Pa. Code §18.402(b) Aug 17, 2026
Rhode Island	What they establish is the standard the treatment itself must meet however it is delivered.	R.I. Gen. Laws §5-37-5.1(19) Sep 3, 2026
South Carolina	The cited rules do not settle this — none of them state a pre-treatment exam requirement; they only make failure to prepare or maintain an adequate patient record disciplinable, and require telemedicine care to meet the same standard as in-person care.	S.C. Code §40-47-110(B)(17) Sep 3, 2026
South Dakota	The cited rules do not settle this — South Dakota's telehealth provision only requires that whoever treats the patient be fully licensed here (or employed by a listed facility) and follow their board's rules; it sets no prior good-faith exam requirement.	S.D. Codified Laws §34-52-2 Sep 3, 2026
Tennessee	Yes — before prescribing or dispensing any drug, the physician or a licensed supervisee under protocols must first do and document a history and physical, diagnosis, therapeutic plan and follow-up, subject to narrow exceptions; telemedicine doesn't waive it.	Tenn. Comp. R. & Regs. 0880-02-.16 (scope) Sep 2, 2026
Texas	Yes — before any delegated cosmetic procedure a physician, PA, or APRN must establish the practitioner-patient relationship and keep an adequate medical record; the rules require that plus written screening criteria, not a specified hands-on exam.	22 TAC §169.26 Jul 26, 2026
Utah	Yes — before a nonablative cosmetic procedure protocol or series begins, a physician, nurse practitioner, or physician assistant with an unrestricted license must develop the treatment plan and evaluate the patient in person or by live telemedicine.	Utah Code § 58-1-506(3)(a) (Supervision of cosmetic medical procedures) Sep 4, 2026
Vermont	Yes — a Vermont-licensed provider may prescribe, dispense, or administer drugs or give treatment recommendations only after an appropriate exam, in person or by telemedicine; signing a blank or undated prescription form is unprofessional conduct.	Vt. Stat. tit. 26, §1354(a)(38) Sep 3, 2026
Virginia	Yes for prescription treatments — botulinum toxin and filler need an appropriate exam by the prescriber, a practitioner in the same group or a consultant, except in a medical emergency; Board of Medicine rules impose no general pre-treatment exam.	18 Va. Admin. Code § 85-20-29(A)(1) Sep 2, 2026
Washington	Washington writes out SEVEN things a physician must do before authorizing a nonsurgical medical cosmetic procedure, rather than naming a “good-faith exam”.	Wash. Admin. Code 246-919-606(5) Sep 2, 2026
West Virginia	The cited rules do not settle this — none of them impose a pre-treatment exam. What they establish is narrower: a physician-patient relationship cannot be created through e-mail, internet questionnaires, text messaging, or other written communication.	W. Va. Code §30-3-13a(c)(1) Sep 3, 2026
Wisconsin	The cited rules do not settle this — Wisconsin requires a physician who treats a patient to disclose reasonable alternative treatments and their benefits and risks, judged by the reasonable physician standard, but state no separate pre-treatment exam duty.	Wis. Stat. § 448.30 Sep 2, 2026
Wyoming	The cited rules do not settle this — they define a physician-patient relationship as one formed to provide diagnosis or treatment, and make diagnosis, prescribing, and judging medical necessity the practice of medicine, but set no pre-treatment exam rule.	Wyo. Stat. Ann. §33-26-102(a)(xx) Sep 3, 2026

Is an exam required before a patient can be treated, state by state

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