Med Spa Marketing Agency: How to Read the Proposal

A med spa marketing agency that promises new patients "or you don't pay" is only as good as its definition of a patient. Two other lines matter as much: the fee and the name on the ad accounts.

Quick answer

• Find the line that says how the agency earns money, then ask what that line rewards.
• Ask for the ad accounts in your name, with the agency added as a partner or manager.
• Define "patient" in the contract as a person who attended a paid treatment.
• Ask for cost per treated client, not cost per lead.
• Ask who signs off on before-and-after photos and influencer posts.

Four ways an agency can be paid

The fee line shows what the agency will push hardest.

A per-lead price rewards getting someone to fill in a form, not the person who actually shows up.

The proposal, line by line

Ask the question beside each line. A good answer names a place you can check yourself.

Who holds the logins

Whoever owns the ad account keeps its history and audiences when the agency leaves. In Google Ads, only Admin users can give account access or unlink manager accounts; Standard users can edit campaigns but can't do either.

If an agency's manager account owns yours, its admins can edit user access too. So you want Admin access on the account itself, not a Standard login.

For Meta, ask for your ad account and Instagram account to sit in a business portfolio under your name, with the agency as a partner. Meta says a partner with full control can't share the asset with another business; only the owner can.

When the agency owns the asset and shares it with you, you get only the permissions it assigned. An ad account created in a business portfolio also stays there permanently, so one the agency creates in its own portfolio never becomes yours. Ask each agency what stays with you if you leave: logins, creative files, audiences and the phone numbers in your ads.

A login check for this week

Do it while you compare proposals, or now if an agency already runs your ads.

1. Open Google Ads. Go to Access and security in the Admin menu, and read the Access level column next to each name.
2. Count the people with Admin access. You should be one of them, and so should one more person on your staff.
3. In Meta Business Suite, open Settings, then Accounts. Check whether the ad account and Instagram account belong to your portfolio or were shared by the agency.
4. Write down what the agency's own login can do that yours can't.
5. If an account belongs to the agency, ask to move it into your name. A Meta ad account made in its portfolio can't move, so open a new one in yours.

What the report has to count

The report should follow people through four steps: lead, booked consult, shown, treated. Your booking software holds the last three.

Boulevard, from my med spa software comparison, said in 2024 that its Google Analytics integration tracks how well Google Ads convert to bookings. It doesn't mention shows or treatments. For any system, ask whether a booking keeps the ad it came from.

Add the treatment and its value. A lip filler client and a laser package client are different revenue, and a report that mixes them hides which ad is worth the money.

Conversions created from the Google Analytics side are set as secondary, so they don't steer bidding until someone changes that. Ask which conversion the campaigns chase: a form fill or a treated client.

Google learns which clicks became a treated client once its conversion import brings those treatments back as conversions. Ask who sends the treatments back to Google, and how often.

Rules the agency's ads live with

Meta's Health and Wellness standard allows before-and-after images for cosmetic procedures, injectables included, in ads aimed at people 18 or older. It also bars copy that attacks a person's appearance. Its change log shows an entry dated July 22, 2026; ask the agency to show the age setting on each ad set.

On Google, Botox and semaglutide sit on a list of prescription drug terms. For US and Canadian campaigns, ads and landing pages may use them without certification, but bidding on them as keywords needs it. If the proposal lists keywords like "botox near me" or semaglutide, ask which certification the account holds.

The same Google policy page says local law still applies. In Canada, Health Canada says Botox marketing to consumers can't refer to its therapeutic use or benefits, and it lists before and after pictures as a common problem.

Google's personalized ads policy lists health as a sensitive category, and its Health page names "invasive medical procedures, including cosmetic surgery, surgical procedures, or injections." Ads promoting them can't use advertiser-curated audiences, which include customer match and your data segments.

That page doesn't name lasers or facials, so the rule is clearest for injectables. Your data segments are what Google used to call remarketing, so an agency that promises Botox retargeting on Google needs to explain how.

In the US, the FTC's consumer reviews rule bans fake reviews and incentives tied to a positive review. Ask whether the agency offers a client anything for leaving one.

The FTC's endorsement guidance adds that a free product can create a disclosure duty, and that your company is ultimately responsible for what others do on its behalf.

In Canada, the Competition Bureau says it is against the law to advertise in a way that is false or misleading. In Ontario, the physicians' college says physicians must not show before and after photos in ads the public is likely to see unsolicited, including ads a third party prepares. I am not a lawyer, and this is not legal advice.

I compare other agency types in healthcare marketing agency, and channels per treatment in med spa marketing.

Sources checked on 2026-10-26.