1. Create a business plan and decide what you want the business to look like in 1, 5, and 10 years. Select a name, create a logo, and select your target audience. Proper planning from the start will help you create goals for the business and obtain financing if needed.
2. In Texas, only physicians can own a medical spa under the corporate practice of medicine doctrine, through a professional limited liability company (PLLC) or professional association (PA). The only exceptions to this are podiatrists, chiropractors, optometrists, and sometimes physician assistants. A layperson can own a management services organization through a limited liability company (LLC) and enter into a management services agreement with a physician and manage the day-to-day, non-medical aspects of the business. If you don’t have a practice lawyer helping you set this up – reach out to us. We can help!
3. Select a medical director and hire medical professionals. Make sure all proper legal documentation is in place, including the medical director agreement, independent contractor agreements or employment agreements, and supervisory agreements for any midlevel practitioners. Provide proper training for all medical professionals to stay on top of the latest procedures and to make your business competitive.
4. You will need to obtain general liability insurance to protect you and your business from lawsuits related to accidents and property damage, malpractice insurance, for protection from lawsuits due to the various services and procedures you perform, and workers’ compensation insurance, to cover lost wages or medical expenses for your employees in the case of a work-related accident. 
5. Decide whether you will provide mobile services or if you will have a physical location. Check with your local town hall to see if local permits are needed to open your medical spa. An updated certificate of use and certificate of occupancy for your space may be necessary if you are leasing a physical space. Make sure to make your space inviting with a cozy, relaxed feel. You want clients to feel welcomed and for the experience you provide to be memorable. Your space must be approved for medical use and if you plan to provide cosmetology services and hire an esthetician, the Texas Department of Licensing and Regulation requires a Salon license. 
6. Select which services you will provide and purchase/lease the necessary equipment to provide those services. It may be a good idea to start with just a few popular services so you are not over-expanding your medical spa business’s capabilities too quickly. You also want to ensure the personnel handling certain pieces of equipment have the proper licenses to do so. For example, non-healthcare persons performing Laser hair removal in Texas need a permit from the Texas Department of License and Regulation.
7. Sales Tax Registration is required if you plan to sell a taxable good or service, like skin care products. 
8. Create a website for potential customers to view and book services. Make this as easy and convenient as possible for customers. A tricky or hard-to-navigate website can discourage potential customers. Have a clear concise call to action, including services offered, how to book services, and spa location, and hours.
9. Establish relationships with vendors and suppliers in the industry to order supplies for the medical spa. This could potentially lead to training from the vendor.
10. The key to growing your clientele will be marketing. Join social media groups on Facebook and start a business page on both Facebook and Instagram to advertise your business. Use buzz hashtags that make your business easily searchable.
11. Ensure the medical spa has documented protocols and procedures in place, a well-drafted employee handbook, and procedure consents for all services you plan to provide.
12. Once all this is complete, you are ready to start seeing clients and enjoying the fruits of your labor. Owning a medical spa can be a fun and rewarding business to partake in.

We hope this guide helps you get started, and for any questions regarding starting your medical spa in Texas – Lengea is here to help!