Owner Attestation


I hereby certify that I have reviewed the MedSpa Board Certification Requirements and affirm that the following statements are true and accurate to the best of my knowledge: </p?

  1. All providers employed or engaged by the facility hold active licenses in good standing with the appropriate state licensing boards.
  2. The designated Medical Director exercises full clinical oversight of the medical spa and retains ultimate authority over all medical services rendered.
  3. All new patients receive a legally compliant Good Faith Exam conducted by a qualified physician, nurse practitioner, or physician assistant, in accordance with the Certification Requirements.
  4. All delegated services are assigned to licensed and properly trained providers in accordance with state law and supervision protocols.
  5. All injectable and prescription products are obtained exclusively from legitimate, authorized sources.
  6. The facility maintains appropriate emergency readiness, including but not limited to protocols for vascular occlusion and burns, and maintains a minimum supply of hyaluronidase on-site.
  7. The medical spa is legally organized and registered in compliance with applicable state laws, including those governing the Corporate Practice of Medicine (CPOM).
  8. I understand and acknowledge that the MedSpa Board reserves the right to revoke certification if the facility is found to be in violation of applicable laws or certification requirements.
  9. I agree to notify the MedSpa Board promptly of any change in the designated Medical Director.
  10. I understand that the application fee is non-refundable.

By signing below, I affirm that the information provided in this application is true, complete, and accurate, and I agree to maintain compliance with all MedSpa Board Certification Requirements.

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Signature Certificate
Document name: Owner Attestation
lock iconUnique Document ID: b9c879442a1c0aa2ef57450d38086ea1d4583861
Timestamp Audit
February 27, 2026 2:26 pm PDTOwner Attestation Uploaded by Margaret Sherman - margaret@medspaboard.com IP 2600:1702:3650:13b0:795e:1676:72cc:d94d
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