FOR FOUNDERS OF KETAMINE, TRT/HRT, IV-THERAPY & MED-SPA CLINICS
Entity architecture, MSO agreements, and a state-specific compliance map from a ketamine clinic lawyer — one flat-fee MSO formation package, starting at $8,500, so you open on a structure built for your state’s rules.
- Harvard Law-trained deal counsel
- Attorneys admitted in Illinois, Wisconsin & New York
- Selected to Illinois Super Lawyers 2025-2026
A Standard LLC Is Not a Clinic Structure
You have the model, the clinicians, the space, and the capital. The temptation is to do what every other founder does: file an LLC, sign the lease, and open. For a coffee shop, that works. For a clinic that prescribes ketamine or testosterone, runs IVs, or delivers aesthetic medicine, the ownership structure itself is regulated — and most states decided a century ago that people who are not physicians cannot own the practice of medicine.
Getting the structure wrong is not a paperwork problem. Corporate practice of medicine violations put clinician licenses in front of the medical board, and management and fee-splitting arrangements that cross the line can be unenforceable — meaning the contracts your business runs on may not protect you when it matters. Ketamine and testosterone are Schedule III controlled substances, which layers DEA and state registrations on top of the entity questions, and telehealth prescribing adds its own constraints. Founders who discover this after opening end up re-papering the entire business mid-operation, renegotiating with clinicians from a position of weakness, and explaining the mess to investors.
Howard East handles the MSO formation before the structure becomes the problem. We design the two-entity MSO structure around your state’s rules — the professional entity that owns the medicine, the management company that owns the business — draft the agreements that connect them, and hand you a launch map for the licenses and registrations your model requires. It is the same structure work behind our ketamine clinic MSO practice, packaged at a flat fee for founders who are building now.
What the Package Includes
- Structure design and formation of both entities. The professional entity (PC or PLLC, as your state requires) and the management company — filed, organized, and documented with governance agreements that reflect who actually controls what.
- Management Services Agreement. The contract that carries the whole MSO structure, drafted around your state’s corporate practice of medicine and fee-splitting rules — management fee design, control allocation, term, and unwind mechanics.
- State regulatory memo for your launch state. Who may own what, physician and mid-level supervision requirements, controlled-substance registrations (DEA and state) for ketamine or hormone models, and the telehealth constraints that apply to your prescribing model.
- Clinical-coverage agreements. The medical director or collaborative-practice agreement your model requires, aligned with the supervision rules in the memo.
- 60-minute launch strategy call plus written launch checklist. The sequence of filings, registrations, and operational steps between signing and seeing your first patient.
The Credentials Behind the Structure
- Regulated-industry licensing experience across seven states
- Attorneys admitted in Illinois, Wisconsin & New York
- Selected to Illinois Super Lawyers, 2025-2026
- Deal counsel trained at Harvard Law School (J.D.)
- Former Series 7 & 66 securities licensee on the team — relevant when your clinic raises outside capital
How the Clinic Formation & MSO Package Works
1. Book the formation call and confirm your quote. Your exact flat fee is set at intake, in writing — the starting at $8,500 base covers the scope below; multi-state footprints and investor structures adjust it, and we tell you exactly why before you pay.
2. Upload your materials securely. Intake questionnaire plus whatever exists: lease or LOI, any entities already formed, clinician licenses, and your service menu. 3. Attorney design and drafting. We handle the MSO formation for your state and model, form the entities, and draft the full agreement set. 4. Delivery: filings, agreements, memo, and strategy call. You receive the formed entities, executed-ready agreements, the state regulatory memo, and a 60-minute call that turns it into a launch sequence.
Scope, in plain terms: the flat fee covers one launch state, the two-entity formation, the agreement set and regulatory memo listed above, and the strategy call. Additional states, securities documents for outside investors, license and registration applications beyond the memo’s roadmap, payor enrollment, and ongoing counsel are separate engagements — scoped and quoted in writing before any additional work begins.
Tell Us About the Clinic You Are Building
We respond within one business day. Your information stays confidential.
Clinic Ownership Questions Founders Ask a Ketamine Clinic Lawyer
Can a non-physician own a ketamine clinic?
It depends on the state. In corporate-practice-of-medicine states, only a physician or physician-owned entity may own the medical practice itself — a non-physician founder participates through a management services organization that owns the brand, equipment, lease, and non-clinical operations, and contracts with the practice. In more permissive states, direct ownership may be available. Getting this wrong risks board discipline for your clinicians and unenforceable contracts. The structure analysis is the first deliverable of our package.
What is an MSO and why do I need one?
A management services organization is the business entity in a two-entity clinic structure. The physician-owned professional entity employs or contracts the clinicians and owns the medical decisions; the MSO owns everything non-clinical — brand, marketing, space, equipment, administrative staff — and is paid under a management services agreement. Done correctly, the MSO structure lets non-physician founders and investors build clinic value without owning the practice of medicine. Done casually, it can violate CPOM and fee-splitting rules.
What licenses do you need to open a ketamine clinic?
Ketamine is a Schedule III controlled substance, so prescribing clinicians need DEA registration and, in many states, a separate state controlled-substances registration, on top of their professional licenses. Depending on the state and model, you may also face facility or office-based-treatment requirements, storage and recordkeeping rules, and telehealth restrictions on any remote prescribing. There is no single “ketamine clinic license” — it is a stack of clinician, entity, and site-level requirements that varies by state.
Are TRT clinics legal?
Yes — testosterone replacement therapy is lawful medical care when properly structured. Because testosterone is a Schedule III controlled substance, the rules are less forgiving than for wellness services: a valid clinician-patient relationship, appropriate exams and labs, compliant prescribing and telehealth practices, and sourcing from licensed pharmacies. The legal risk in TRT is rarely the therapy itself; it is ownership structure, marketing claims, and prescribing practices. Our package addresses the structure directly and flags the rest in the memo.
How much does MSO formation cost to set up?
MSO formation costs scale with the number of states, entities, licensed professions, and investors involved. Howard East’s clinic formation and MSO package is a flat fee starting at $8,500, with your exact number quoted in writing after a short intake — before we begin. Multi-state footprints, outside investors, and custom equity arrangements move the quote up, and we tell you exactly why. There are no hourly surprises inside the defined scope.
Does the corporate practice of medicine rule apply to my state?
Broadly: strongly in states such as California, Texas, and New York; more loosely or not at all in others — and enforcement posture varies by medical board even where the doctrine is long-standing. Nurse-practitioner-owned models raise a parallel question under scope-of-practice and professional-entity rules. The honest answer requires reading your state’s statutes, board positions, and entity laws together — which is exactly what the package’s state regulatory memo does for your launch state.
Attorney Advertising. Howard East is a business law firm; attorneys are admitted in Illinois, Wisconsin & New York and work with local counsel where required. This page provides general information, not legal advice, and reading it does not create an attorney-client relationship. Flat-fee scope is defined above; engagement terms and final pricing are confirmed in writing at intake.