Quick answer: Virginia requires a bona fide practitioner-patient relationship established through a synchronous examination before prescribing controlled substances or compounded medications via telehealth (Va. Code §54.1-3303). The Virginia Board of Medicine and Board of Pharmacy coordinate enforcement against telehealth programs prescribing without proper GFE.
How Virginia expects the GFE to be conducted — modality, technology, and clinical interaction requirements.
Virginia note: Synchronous audio-visual is required for establishing the bona fide practitioner-patient relationship. Audio-only is not generally sufficient for new-patient GFE for compounded medications, controlled substances, or aesthetic treatments under Virginia rules.
Virginia-licensed physicians (MD/DO), nurse practitioners with prescriptive authority (autonomous after 2 years post-graduate or with a practice agreement), and physician assistants under physician supervision. The performing provider must hold a current Virginia license and prescriptive authority appropriate to the medication.
What Virginia regulators expect to see in a defensible GFE chart note. Template-only documentation is explicitly cited as inadequate in disciplinary actions.
Virginia requires GFE before prescribing controlled substances, compounded medications including GLP-1 and hormone therapy, before performing aesthetic medical procedures, and before ordering diagnostic studies. Va. Code §54.1-3303 explicitly prohibits prescribing controlled substances without a bona fide practitioner-patient relationship.
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Virginia has joined the multi-state enforcement wave against compounded GLP-1 telehealth programs in 2025-2026. The Board of Medicine and Board of Pharmacy have coordinated audits of telehealth aesthetic and weight-loss programs, citing inadequate GFE and chart documentation as primary deficiencies.
The specific Virginia statutes and regulations that establish and enforce GFE requirements.
Requires a bona fide practitioner-patient relationship before prescribing controlled substances — Virginia's statutory GFE framework for controlled prescribing.
Establishes telemedicine practice standards in Virginia, including the requirement that telemedicine providers meet the same standard of care as in-person practice.
Virginia Board of Medicine regulations on prescribing standards, including examination, documentation, and chart review requirements.
Regulatory Information Disclaimer
The telehealth compliance information for Virginia presented on this page is provided for general informational purposes only and should not be construed as legal advice. The telehealth regulatory landscape is evolving rapidly, with state legislatures, medical boards, and federal agencies frequently updating rules, guidance, and enforcement priorities. While TrueEval makes every effort to keep this information current and accurate, we cannot guarantee that all details reflect the very latest regulatory changes at the time of your visit.
We strongly recommend consulting with a qualified healthcare attorney or compliance professional before making business decisions based on this information. For the most current regulatory requirements, refer directly to your state medical board and relevant licensing authorities. Last reviewed: February 2026.
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