Is an exam required before a patient can be treated in North Carolina?
Intake · part of The Practice Perimeter
Short answer
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.
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.
Drawn from 4 verified rules in this section · regulatory monitoring, not legal advice
- NC Board of Nursing, Cosmetic/Aesthetic Dermatological Procedures Position Statement (rev. 9/2022) · Aug 17, 2026
- NCMB Position Statement 5.1.2 · Aug 17, 2026
- NC Board of Nursing, Cosmetic/Aesthetic Dermatological Procedures Position Statement (rev. 9/2022) · Aug 17, 2026
- NCMB Position Statement 5.1.4 (Telemedicine — licensee-patient relationship; evaluations and examinations) · Sep 8, 2026
Related North Carolina rules
A licensed physician, nurse practitioner, physician assistant or other practitioner with prescriptive authority must complete the client evaluation and assessment for the appropriateness of the procedure and issue the prescription or order before a licensed nurse carries it out. That evaluation may not be delegated to the nurse who will perform the treatment.
NC Board of Nursing, Cosmetic/Aesthetic Dermatological Procedures Position Statement (rev. 9/2022) · verified Aug 17, 2026
The Medical Board’s position is that each patient be examined by a physician, physician assistant, or nurse practitioner licensed or approved by the Board prior to receiving the first laser hair or tattoo removal treatment, and at other times as medically indicated.
NCMB Position Statement 5.1.2 · verified Aug 17, 2026
How other states answer this
- Alabama
- Alaska
- Arizona
- Arkansas
- California
- Colorado
- Connecticut
- Delaware
- District of Columbia
- Florida
- Georgia
- Hawaii
- Idaho
- Illinois
- Indiana
- Iowa
- Kansas
- Kentucky
- Louisiana
- Maine
- Maryland
- Massachusetts
- Michigan
- Minnesota
- Mississippi
- Missouri
- Montana
- Nebraska
- Nevada
- New Hampshire
- New Jersey
- New Mexico
- New York
- North Dakota
- Ohio
- Oklahoma
- Oregon
- Pennsylvania
- Rhode Island
- South Carolina
- South Dakota
- Tennessee
- Texas
- Utah
- Vermont
- Virginia
- Washington
- West Virginia
- Wisconsin
- Wyoming
Related North Carolina questions
- Can the pre-treatment exam be done by telehealth in North Carolina?
- Who may perform the pre-treatment exam in North Carolina?
- Must someone be on site while a patient is treated in North Carolina?
- Can a med spa in North Carolina offer compounded semaglutide or tirzepatide?
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