What Every Aesthetic, Wellness, and IV Therapy Practice Needs to Know About Delegation Agreements

If you operate in the aesthetic, wellness, or IV therapy space, you’ve likely encountered the term delegation agreement (and maybe even signed one). These documents define how a physician delegates certain medical tasks to a nurse practitioner (NP), physician assistant (PA), or other licensed provider.

Unfortunately, many practice owners rely on generic templates they find online. These “one-size-fits-all” documents often lack state-specific compliance language, omit key oversight details, and can expose providers to serious medical board or OIG investigations.

A well-drafted delegation agreement, however, is a critical safeguard. It clearly defines responsibilities, scope of practice, and reporting expectations—protecting both your license and your business.

Below, our attorneys outline the four key components every delegation agreement should include for aesthetic, wellness, and IV therapy practices.

1. Initial Consultation and the Good Faith Exam (GFE)

In the aesthetics, wellness, and IV therapy space, the initial consultation, often referred to as a Good Faith Exam (GFE), is more than a formality. It’s the foundation of a legitimate provider–patient relationship and a core compliance requirement.

A GFE is a medical assessment performed by a qualified provider, such as a physician, NP, or PA, before any treatment is administered. During the exam, the provider must:

• Take a comprehensive medical history

• Review the patient’s medications and health status

• Evaluate candidacy for treatment

• Document findings and recommendations in the patient’s chart

While this may seem routine, GFEs are under increasing scrutiny by state medical boards and the Office of Inspector General (OIG)—particularly in the medical aesthetics and IV therapy industries.

Each state regulates who can perform a GFE and how it must occur. In some states, the physician must perform the GFE in person. Others allow an NP or PA to complete the exam, provided there is proper physician oversight, review, and documentation. Some states also permit the use of telehealth, but only if the GFE meets the state’s verification and supervision standards.

Your Delegation Agreement should clearly define:

• Who is authorized to perform the GFE

• How the GFE must be conducted (in-person or telehealth)

• When a physician must review or co-sign

• What documentation must be maintained

  
  

Ultimately, the GFE protects both the patient and the provider. It ensures each patient receives an appropriate medical evaluation and that your practice operates within state law.

At Marti Law Group, we regularly counsel providers that skipping or mishandling this step can lead to serious compliance consequences, including medical board investigations or license discipline. A strong Delegation Agreement provides the clarity and structure needed to prevent those risks.

2. Delegated Duties and Procedures

Every duty delegated to another provider must be clearly stated in writing. Ambiguity is one of the most common—and costly—mistakes we see.

If an NP, PA, or RN performs injectables, IV therapy, or laser treatments, your Delegation Agreement should list each service, include references to approved protocols, and note any required physician involvement.

This protects both parties:

• The delegating provider shows they’ve set appropriate clinical boundaries.

• The delegatee avoids liability for acting outside of their authorized scope.

  
  

State medical boards often publish lists or guidance about which duties may be delegated. Your attorney should tailor your agreement accordingly to stay compliant.

3. Scope of Practice Alignment

Few issues attract more scrutiny than scope of practice violations—when a provider performs services beyond what their license allows or a physician delegates duties improperly.

These violations can result in fines, license suspension, or even criminal charges.

Your Delegation Agreement should:

• Reference state-specific scope of practice laws for each provider type.

• Affirm that the delegatee will only perform services within their licensed scope.

• Include details about any training or certifications required for specialized procedures (such as lasers, IV infusions, or injectables).

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Maintaining compliance with scope of practice laws not only protects your license—it safeguards your patients and your reputation.

4. Oversight, Communication, and Reporting

Delegation is not a “set it and forget it” relationship. Ongoing oversight, communication, and documentation are vital to a compliant practice.

Best practices include:

• Weekly or biweekly chart reviews between the delegating physician and delegatee

• Clearly defined availability hours for supervising providers

• Designated on-call coverage for emergencies

• Periodic review of treatment outcomes and compliance logs

  
  

Your Delegation Agreement should explain these expectations in detail. Establishing consistent communication protocols helps ensure clinical quality and demonstrates compliance in the event of an audit or board review.

Why Your Delegation Agreement Should Never Be a Template

Even if two practices offer similar services, their Delegation Agreements should never be identical. Each must reflect:

• The state’s medical and nursing board regulations

• The structure of your ownership and provider relationships

• The specific treatments and devices used in your practice

  
  

Using a “boilerplate” form from the internet (or borrowed from a colleague) can create dangerous gaps in compliance and leave your business vulnerable to investigation.

Have an attorney create custom Delegation Agreements that align with their business model, provider team, and state-specific laws.

Frequently Asked Questions About Aesthetic Practice Delegation Agreements

1. Who can perform a Good Faith Exam (GFE) in an aesthetic, wellness, or IV therapy practice?

The answer depends on your state’s medical board regulations. In most states, a physician, nurse practitioner (NP), or physician assistant (PA) may perform the GFE—but only within their defined scope of practice. Some states require the physician to conduct the exam in person, while others permit delegation if proper oversight and review are in place. Always confirm who is authorized in your state before offering medical services.

2. Is a Delegation Agreement the same as a Supervisory Agreement?

Not quite. A Delegation Agreement defines which specific duties a physician authorizes another provider to perform. A Supervisory Agreement governs how that oversight occurs, including review frequency and reporting expectations. Many states require both for aesthetic, IV, or wellness practices.

3. Do I need a Delegation Agreement if I own a med spa, IV therapy clinic, or wellness center but I’m not a physician?

Yes. If your business offers medical or aesthetic services that require physician oversight—such as injectables, IV drips, or laser treatments—a compliant Delegation Agreement is required. It establishes how your medical director delegates those medical acts to other licensed providers and ensures your operations remain within legal limits.

4. How often should a physician review delegated work or meet with staff?

Delegation requires regular oversight. The best practice is to meet weekly or biweekly to review charts, patient outcomes, and compliance documentation. Some states mandate review intervals, so it’s critical to follow your jurisdiction’s specific requirements.

5. What happens if my Delegation Agreement isn’t compliant?

An incomplete or outdated Delegation Agreement can expose both the physician and the practice to serious liability—including medical board action, civil penalties, or license suspension. Many enforcement cases arise from agreements copied online or borrowed from colleagues without legal review. Working with a healthcare attorney ensures your document meets all state-specific requirements.

Key Takeaway

A Delegation Agreement isn’t just a formality. It’s a cornerstone of legal compliance and patient safety in the aesthetic, wellness, and IV therapy industries. Investing in a properly drafted agreement protects your providers, patients, and practice from avoidable risk.

If you’d like to review your current agreement or discuss a new one, our attorneys are here to help. Contact us to learn more.