The Right Clinician, The Right State
Providers licensed where the patient physically is, working inside their own scope. A clearance from a clinician licensed three states away is not a clearance.
Telehealth Setup & Clearance
A Live Telehealth Clearance Before Anyone Picks Up a Syringe
Live telehealth clearances for aesthetic and wellness clinics. A licensed provider evaluates the patient, decides, and leaves your team an order they can act on — so treatment starts from a documented decision rather than an assumption.
What It Is
Who Decides the Patient Can Be Treated?
Injecting a neurotoxin or running an infusion is a medical act, and someone with a license has to make the call. That is what a clearance is: the moment a physician, NP or PA takes clinical responsibility for this patient receiving this treatment today, and writes down why. Your injector executes that decision — they do not make it.
Skip it and the problem is not paperwork, it is authority. There is no clinician of record, so the treatment was performed on nobody’s judgment, and the license most exposed is the one belonging to whoever held the syringe. We put a real clinician in that seat, in the right state, with the decision recorded.
Service Details
Three Things We Get Right
Fast Enough for a Real Schedule
A bench of providers rather than one, so a patient in your chair is not waiting on a single calendar. Clearance is measured against your appointment, not our queue.
A Decision You Can Show
History reviewed, contraindications considered, treatment authorised or declined — with the reasoning captured. If anyone ever asks, you produce a file rather than a recollection.
The WorkflowStep 01 Step 02 Step 03 Step 04
From Chair to Clearance in Four Moves
Patient Answers Questions
History, medications and consent — collected in the clinic or sent ahead of the appointment, structured for the treatment being requested.
Your Team Requests It
Your nurse or coordinator raises the request in the platform. No calls to find someone, no forms sent into a fax queue.
A Provider Evaluates
The provider reads the file, meets the patient live, and asks whatever the intake did not cover.
A Decision Is Recorded
Approved with orders, approved with conditions, or declined — noted with the interval it stays valid for, and visible to your staff.
Two Ways to Run a Clearance — and They Are Not Interchangeable
Telehealth exams run either synchronously — a live, real-time encounter between provider and patient — or asynchronously, where the patient submits information and a provider reviews and clears it later. Some states accept both for aesthetic and wellness treatment. Some accept async only for certain services. Some require a live encounter before any prescription. Which one your clinic may use is a state question, and getting it wrong is the most common exposure we find.
Mode OneLive Encounter
Synchronous — Real Time
The provider and the patient are present at the same moment, by video or by phone where the state allows it. The provider can ask follow-up questions, see the patient, and clear or decline on the spot.
How It RunsLive two-way video between provider and patient
Provider reviews history, then examines and questions in the encounter
Clearance and any prescription issued during the same visit
Encounter time, modality and participants recorded in the note
First-time patients, higher-risk treatments, controlled or weight-management prescribing, and any state that requires a live encounter before a script.
Slower to schedule — plan for provider availability at your busiest hours.
Mode TwoStore and Forward
Asynchronous — Reviewed Later
The patient submits history, photographs and consent through the intake, and a licensed provider reviews the file and issues the clearance without a live meeting. Often called store-and-forward.
How It RunsPatient completes structured intake, photos and consent before arrival
Provider reviews the submitted file and the treatment request
Clearance, orders or a decline returned with the reasoning documented
Escalation to a live encounter when the file raises a question
Established patients, repeat treatments inside an existing clearance window, and lower-risk services in states that permit async review.
Not accepted everywhere — several states require live video for a first prescription.
Our Position
Synchronous Is the Stronger Standard — Legally and Clinically
Both modes can be lawful where a state permits them, but they do not carry equal weight. A live encounter is accepted in every state that allows telehealth at all, satisfies the strictest reading of what establishes a provider-patient relationship, and produces a record that is far harder to challenge. Asynchronous review is narrower: it is permitted in fewer states, more often limited by service type, and more likely to be revisited as rules tighten.
Accepted More Widely
A live encounter is recognized in every state that permits telehealth. Async is allowed in fewer states, and often only for specific services — so a single workflow does not travel across state lines.
A Harder Record to Challenge
The note shows a real-time encounter with a documented modality, duration and participants. That is materially stronger evidence that a provider-patient relationship existed than a reviewed form.
Better for the Patient
The provider can see the patient, ask the follow-up question a form would never prompt, and catch a contraindication the intake missed — then decline or redirect before treatment rather than after.
What we recommend: run synchronous by default, and use asynchronous only where your state clearly permits it for that specific service and the patient is established. Your protocols name the mode allowed per service per state, and the platform routes the request accordingly — so your RN is never deciding on the spot whether a store-and-forward review is good enough.
This is our operational position, not a legal opinion. Telehealth and delegation rules differ by state and change; your medical director and your counsel confirm what applies to your clinic.
One Platform. Every Workflow.
Clear and Prescribe Together
Where a script belongs with the visit — weight-management, hormone therapy, certain injectables — the provider writes it in the same encounter instead of scheduling a second one.
One EncounterPaperwork Already Done
History, consent and treatment-specific questions reach the patient ahead of time and come back attached to the record, so nobody is filling in forms at the front desk.
Before ArrivalStraight to the Pharmacy
A signed script routes to a partner 503A or 503B pharmacy licensed for that patient, or to whichever pharmacy your clinic already uses.
Straight to FillFAQ
Frequently Asked Questions
Still not sure? Twenty minutes on the phone answers what a page can't.
What Exactly Is a Clearance?
A licensed provider evaluating a specific patient for a specific treatment and taking clinical responsibility for that decision. It is what makes your injector’s work a delegated medical act with a clinician behind it.
Can It Be Done Over Telehealth?
In most states, with a live encounter and a proper record. Where a state will not accept telehealth for a given service, we tell you that instead of building you a workflow that fails quietly.
Who Is Allowed to Do It?
A physician, NP or PA acting within their scope and licensed where the patient is. Which of those a state accepts depends on the state and the treatment.
What Kinds of Clinics Do You Cover?
Med spas, IV and infusion clinics, weight-management programs, hormone practices and telehealth-first clinics — with providers licensed in each state where you see patients.
How Long Is a Clearance Good For?
It varies by state and by treatment, and the provider sets the interval as part of the decision. Your protocols record what applies to each service you offer rather than assuming one number covers everything.
What's the Difference Between a Sync and an Async Exam?
A synchronous exam is a live encounter — provider and patient at the same time, by video. An asynchronous exam is store-and-forward: the patient submits history, photos and consent, and a provider reviews and clears the file later. Both are real telehealth; which one you may use depends on your state and the service.
Which One Should My Clinic Use?
Synchronous by default. It is accepted in every state that permits telehealth, produces a stronger record, and does more for the patient. Use async only where your state clearly allows it for that specific service and the patient is established — your protocols set that rule per service so staff are not deciding case by case.
Is Async Actually Legal?
Where a state permits it for the service in question, yes — but it is permitted in fewer states, more often limited by service type, and more exposed if rules tighten. It is a narrower tool, not an equivalent one.
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General information about how these workflows are structured, not legal advice. Requirements vary by state; your medical director and counsel confirm the specifics for your clinic.