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

Short answer
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 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.