How to Verify What Your State Actually Requires (Without a Lawyer)
Published September 22, 2026 · 5 minute read
Every med spa and IV hydration owner eventually asks the same question in a forum, a group chat, or a search bar: what does my state require? And every answer that comes back is wrong for someone, because the person answering is in a different state, or answered two years ago, or is describing what their board told them about their practice type, not yours.
This is not a problem a template can solve. It is not, strictly, a problem a lawyer solves either; a lawyer gives you an opinion on a date, and the opinion ages. What the practice needs is a verification trail: a written record of each governance question, which authority was asked, what it said, and when. This is how to build one.
Why the question has no single answer
Aesthetic and IV practices sit across several regulators at once. Nursing boards decide what a nurse may do and under what delegation. Medical boards decide what a physician must personally do and how supervision works. Pharmacy boards govern how products are sourced, stored, and compounded. Cosmetology boards may govern esthetic services in the same room. Health departments may hold facility, waste, and reporting rules. Corporate practice doctrine, where it applies, decides who may own the practice at all.
Each of those bodies answers only its own question, and the split between them is different in every jurisdiction. So "what does my state require" is really eleven questions, each with its own authority, and the honest answer to all of them is: go ask, and write down what they said.
The eleven questions
These are the questions, and the type of authority that usually holds the answer. The authority for your jurisdiction is the one you verify.
- Who may perform each procedure the practice offers, and under what delegation or supervision. Nursing and medical boards.
- Whether a prescriber evaluation is required before treatment, whether telehealth satisfies it, and how long it remains valid. Medical board.
- Whether standing orders are permitted for these services, or whether patient-specific orders are required. Medical and nursing boards.
- The supervision level required: on site, available, or independent. Nursing and medical boards.
- Ownership and corporate practice rules for the practice. Medical board, and counsel where the answer is unclear.
- Record retention period and access rules for patient records. Medical board, health department.
- Product sourcing and compounding rules, including what may be prepared on site and by whom. Pharmacy board.
- The scope boundary between esthetic and medical services in the same practice. Cosmetology and medical boards.
- Mobile or offsite service rules, if the practice travels. Nursing board, health department.
- Adverse event and regulatory reporting obligations: what must be reported, to whom, within what window. Medical board, health department.
- Emergency equipment and medication requirements for the setting. Medical board, health department.
How to record an answer
One row per question. Five columns: the question, the authority consulted, the date, the source (a rule number, a published guidance document, a named person at the board, a written response), and who at the practice verified it. Then a signature block for the person who did the work and the accountable prescriber who accepted it, and a next-review date.
Three rules make the trail worth having.
A row with no date is not verified. It is a belief. The date is what lets the practice later say "this was correct as of this day," which is the only claim anyone can honestly make about a rule.
Blank rows are honest. A question the practice has not yet asked should sit there empty, visibly. Filling it with what a forum said is worse than leaving it blank, because it looks verified and is not.
A written source beats a phone call, and a phone call beats a memory. When a board answers by phone, record the name, the date, and what was said, then ask whether there is a published document that says the same thing. There often is.
When to redo it
On the schedule the practice writes on the page, and every time something changes: a new service, a new role, a new location, a change in who supervises or how. Rules also change on their own. A verification trail with a next-review date is a living document. One without is a snapshot that will eventually be wrong and will not know it.
What this is not
It is not legal advice, and it does not tell you what your state requires. Nothing on this page does, on purpose. It is a method for finding out and proving that you did. Any document that arrives at your practice already claiming to know the answer for your jurisdiction has made a promise its author could not keep, and a reviewer will know that too.
Every Scope & Standard framework ships with a one-page version of this trail at the front, blank, because the practice's own verified answers are the only ones that belong there.
The regulator is not impressed by the practice that knows the rules. It is impressed by the practice that can show when it checked.
Questions this guide answers
Who regulates med spas?
It depends on the jurisdiction and on what is being done. Nursing boards, medical boards, pharmacy boards, cosmetology boards, and health departments each hold a piece, and the split is different in every state. The only reliable way to know which one governs a given question in your location is to ask it directly and record the answer with a date.
Can a template tell me my state's requirements?
No, and one that claims to should be treated with suspicion. Rules change, interpretations vary, and a document written for every state is accurate for none. What a good framework provides is the list of questions and a place to record your own verified answers.
How often should verification be repeated?
On a schedule the practice sets and writes down, and any time a service, role, location, or supervision arrangement changes. The verification page should carry a next-review date.