The most important questions to ask a med spa marketing agency are how they measure booked consults and revenue, who owns the ad accounts and data, how they keep ads for injectables and weight loss within platform rules, what happens to each lead after it comes in, and how you can leave. An agency that answers those five clearly is worth a deeper look; one that changes the subject is not.
This guide is for med spa owners and managers comparing agencies, or wondering whether the one they have is working. It gives you 12 questions to ask on the sales call, what a good answer sounds like, the red flags that should end the conversation, and a one-page scorecard to compare agencies side by side.
Key takeaways
- Judge an agency by booked consults and revenue per dollar spent, not clicks, impressions, or "leads."
- Your business should own its ad accounts, pixels, CRM, website, and data. On Google Ads, an agency's manager account does not take your account away, and you can unlink it.
- Ask how they handle restricted treatments: prescription drugs like GLP-1s cannot be promoted freely on Google or Meta, and some need LegitScript certification.
- Most lost revenue happens after the click. Ask who answers a new lead, how fast, and how bookings reach your calendar.
- Get the contract terms in writing: length, cancellation, setup fees, and whether ad spend is separate from the fee.
Why these questions matter for a med spa
Most med spas are small businesses with a lot at stake in every marketing dollar. The American Med Spa Association's 2024 State of the Industry recap counted 10,488 med spa locations in the US, found that 81% are single-location businesses, and put average annual revenue at about $1.4 million. For a single location, a few months with the wrong agency can cost more than the agency fee itself.
The questions below are grouped by where agencies tend to fall short: measurement, ownership, compliance, follow-up, and the contract.
Results: how will you measure success?
1. What will you report on every month?
Listen for booked consults, shows, treatments sold, and revenue by lead source. Clicks and cost per lead are useful inputs, but they are not the result. A med spa can get cheap leads that never book.
Red flag: reports that stop at impressions, clicks, and "leads generated."
2. How will you connect a booking or a sale back to the ad that produced it?
A good answer names the mechanics: tracking from the form or call into your CRM, the booking landing on your calendar with its source attached, and revenue pulled from your booking system or EMR. Without that link, nobody can tell which campaign is worth more budget.
Red flag: "We can't see your sales, so we optimize to leads."
3. Can I talk to a med spa client with a similar setup?
Ask for a reference with a similar size, market, and service mix (injectables, body contouring, lasers, weight loss). Ask that owner what changed in consults and revenue, not whether they like the team.
Ownership: what do I own if we part ways?
4. Who owns the ad accounts, pixels, and data?
You should. Your ad accounts, Meta business assets, pixels, Google Analytics property, CRM, and lead lists should sit in your business's name, with the agency given access. On Google Ads, Google's own help page on client account ownership explains that linking your account to an agency's manager account does not take ownership away: you keep your data and can remove the agency by unlinking.
Red flag: "We run everything out of our accounts" with no plan to hand them over.
5. Who owns the website, landing pages, and domain?
Same rule. If the agency builds pages on its own platform, ask what you get if you leave: the pages, the copy, the images, and the form history.
6. Who owns the creative?
Photos, videos, ad copy, and before and after images (with patient consent on file) should be licensed to you, not rented.
Compliance: will these ads stay approved?
7. How do you handle ads for injectables, weight loss, and other prescription treatments?
Google and Meta restrict ads that promote prescription drugs. Promoting GLP-1 weight loss or naming brand-name injectables in an ad can get ads rejected or accounts restricted, and some business models need LegitScript certification first. A good agency will explain whether your treatments can be named, and how they advertise benefits and consults instead when they cannot.
Red flag: "We run semaglutide ads for everyone, no problem."
8. Will you handle patient information, and will you sign a BAA?
If the agency's tools will store or transmit patient health information for you, such as a CRM tied to treatments or a texting platform used with patients, it may be a business associate under HIPAA and need a business associate agreement. Ask which of their tools will touch patient data and how they keep it out of ad platforms. Our guide to HIPAA compliant text messaging covers the texting side.
Follow-up: what happens after a lead comes in?
9. Who responds to a new lead, and how fast?
This is where most med spa revenue is lost. A good answer covers the first text or call within minutes, what happens after hours, and how phone calls the front desk misses get answered. See why minutes matter in our guide to speed to lead.
Red flag: "We send you the leads; follow-up is your team's job" with no plan to help.
10. How do bookings reach my calendar, and how do you cut no-shows?
Ask whether leads can book directly into your scheduling system, and what confirmations and reminders go out. Our guide to text appointment reminders covers the timing that works.
The contract: how do I leave if it is not working?
11. What is the term, and how do I cancel?
Get the minimum term, notice period, and cancellation process in writing. Long lock-ins are not automatically bad, but they should come with clear performance commitments.
12. What exactly am I paying for?
Ask for the monthly fee, setup fees, and tool costs separately from ad spend, and whether the fee changes as spend grows. You should be able to see your actual ad spend in your own ad accounts.
A one-page scorecard for comparing agencies
Score each agency from 0 to 2 on every row (0 = no answer, 1 = vague, 2 = clear and specific). A strong agency scores 18 or more out of 24.
| Question | Clear answer sounds like | Red flag |
|---|---|---|
| Monthly reporting | Consults, shows, revenue by source | Clicks and impressions only |
| Sale to ad tracking | CRM, calendar, and EMR revenue tied to source | "We optimize to leads" |
| Reference client | A similar med spa you can call | No references, or only testimonials |
| Ad account ownership | Accounts in your name, agency access | Agency-owned accounts |
| Website and domain | You own pages, domain, and form history | Pages locked to their platform |
| Creative | Licensed to you, consent on file | Rented creative |
| Restricted treatments | Clear rules for what can be named | "No problem" for prescription drug ads |
| Patient data and BAA | Knows which tools touch PHI | Never heard of a BAA |
| Lead response | Minutes, including after hours | "Follow-up is your job" |
| Booking and reminders | Direct booking plus reminders | Leads emailed to the front desk |
| Term and cancellation | In writing, with clear terms | Vague or verbal only |
| Fees vs ad spend | Fee, setup, tools, and spend shown separately | One blended number |
How we answer these questions
We are solutions engineers, so our answers start with measurement. We judge campaigns by consults booked and dollars earned, not clicks, and our monthly reports follow each group of leads at 30, 60, and 90 days. We are tool agnostic and work with whatever booking system, EMR, and CRM a med spa already runs. For clinics that cannot or do not want to pursue LegitScript, we advertise benefits and consults rather than specific medications.
That approach is behind our med spa results. For Advanced Skin Fitness, the first clinic Allergan chose to teach others how to sell CoolSculpting, we helped make it the number one clinic for CoolSculpting volume in Texas, with 340% revenue growth over three years. For Metro Laser, more than 60% of website visitors became leads and monthly sales conversations grew 500% with no added headcount. See how we work with med spas and aesthetic clinics.
Frequently asked questions
What should I ask a med spa marketing agency before hiring them?
Ask how they measure booked consults and revenue, who owns the ad accounts and data, how they keep ads for injectables and weight loss within platform rules, who responds to new leads and how fast, and what the contract term and cancellation terms are.
Who should own my med spa's ad accounts?
Your business should. Ad accounts, pixels, analytics, CRM, and lead data should be in your name with the agency given access. On Google Ads, linking to an agency's manager account does not remove your ownership, and you can unlink it.
Can a med spa advertise Botox or semaglutide on Google and Meta?
Ads that promote prescription drugs are restricted on both platforms, and some models need LegitScript certification. Many med spas advertise consults, results, and benefits instead of naming the drug. Ask any agency to explain exactly what they will and will not run.
What results should a med spa expect from an agency?
Expect reporting on booked consults, shows, and revenue by source, and a plan to improve each. Be wary of promises about lead volume or cost per lead without a plan for booking and follow-up.
What are red flags in a med spa marketing agency?
Agency-owned ad accounts, reporting that stops at clicks, "no problem" answers about prescription drug ads, no plan for lead follow-up, no reference clients, and contract terms that are vague or only verbal.
If you want straight answers to these 12 questions about your own med spa, book a call.