What Decisions Should a Clinic Record Before Signing a Lease?

Published September 23, 2026 · 2 minute read

Before signing a lease, record every decision that the space will make hard to reverse: which services the room layout assumes, who verified that the space can be used for them, what the build-out depends on, and who owns each open question. A lease is the first commitment that locks other decisions in place, so the decisions behind it deserve a written record, not a memory.

Why the lease is the first real decision point

Most opening problems trace back to an assumption made before the lease that nobody wrote down. A treatment room sized for one service turns out to be wrong for the next. A sink, a storage area, or a private space was assumed and never confirmed. By the time the gap shows, the lease is signed and the fix costs money.

A pre-lease decision record does not tell you whether a space is suitable. That answer belongs to the professionals and authorities you consult. The record makes sure each question was asked, answered by someone named, and dated.

What the record looks like

Keep one page per decision. Each page states the decision, the options considered, who made the call, what it depends on, and what would force a revisit. File the pages in the opening binder behind the lease itself, so anyone reading the lease later can see why it was signed.

What to record

• Decision statement, one sentence
• Services the space is expected to support
• Questions verified, with who answered and the date
• Open questions, each with an owner and due date
• Dependencies on build-out, equipment, or vendors
• Conditions that would trigger a review
• Decision owner signature and date

The full opening sequence, including where the lease falls, is in How to Open a Med Spa. For tracking the open questions this page creates, see the open questions register.