Setting up an aesthetic clinic in Kerala: a compliance checklist

Opening an aesthetic or hair-restoration clinic involves more paperwork than most doctors expect. Use this checklist to plan, and to ask your advisers the right questions.

1. Registration as a clinical establishment

• Kerala Clinical Establishments (Registration and Regulation) Act, 2018: clinics in Kerala must register with the registering authority under this Act. Check which category your clinic falls into, the minimum standards for that category, and whether you need to renew.
• Your own registration: a valid registration with the Travancore-Cochin Medical Council or the NMC for every doctor who treats patients, displayed as required.
• Scope: every procedure you offer should be within the registered qualification of the doctor performing it. For hair transplantation, read the NMC's 2022 guidance on who should preferably perform it.

2. Premises and local-body approvals

• A licence from the local body (corporation, municipality or panchayat) for the premises and the activity.
• Fire-safety clearance where it applies to your building and its occupancy.
• Building-use permission that allows a clinic at the address.
• Registration under the Kerala Shops and Commercial Establishments Act if you employ staff, plus the labour-law registrations that follow.

3. Biomedical waste

• Bio-Medical Waste Management Rules, 2016: authorisation from the Kerala State Pollution Control Board, and a contract with an authorised common biomedical waste treatment facility.
• Colour-coded segregation at the point of generation, sharps containers, and staff training.
• Records of waste handed over, and the annual reports required under the rules.

4. Drugs, devices and the procedure room

• Prescription medicines: botulinum toxin, local anaesthetics and many others are prescription-only. Buy from licensed distributors and keep invoices that show batch numbers.
• Storage: follow the cold-chain and storage requirements on the product label, and keep a temperature log for the fridge.
• Devices: buy lasers and energy-based devices from suppliers who can show regulatory compliance and give you service and training records. Set up laser safety: eye protection, controlled access and signage.
• Emergencies: keep a resuscitation kit and oxygen, and have trained staff and a written escalation pathway to the nearest hospital. For HA fillers, keep hyaluronidase on site.
• Sterilisation: autoclave validation, instrument tracking and infection-control protocols.

5. Consent, records and data

• Procedure-specific, written informed consent in a language the patient understands.
• Medical records: the IMC (Professional Conduct, Etiquette and Ethics) Regulations, 2002 require records to be kept for at least three years. Many advisers recommend keeping them longer for surgical and aesthetic work.
• Clinical photographs: take them with consent, store them securely, and limit who can see them.
• Digital Personal Data Protection Act, 2023: a lawful basis and notice for collecting patient data, security safeguards, and a process for handling requests and breaches. This covers website forms and WhatsApp enquiries too.

6. Tax and finance

• GST: healthcare services by clinical establishments are generally exempt, but the exemption excludes hair transplants and cosmetic or plastic surgery, except where the procedure restores or reconstructs anatomy or function. Many aesthetic services are therefore taxable. Get advice before you set prices.
• Professional tax, income-tax registration (PAN/TAN) and payroll compliance for staff.
• Professional indemnity insurance that explicitly covers the aesthetic and surgical procedures you perform.

7. Advertising and patient communication

Since 6 October 2026, the NMC's Guidelines on Ethical Advertising and Public Communication govern how you can promote the clinic. That means no patient counts, success rates, superlatives, before-and-after photographs, testimonials or influencer endorsements, and you are responsible for whatever your agency publishes. See our summary of the guidelines.

8. People and protocols

• Written protocols for each procedure, including the complication pathway.
• A clear supervision structure for any staff who assist with procedures.
• Training records for sterilisation, waste handling, emergencies and data protection.

Before you open: a last check

1. Clinic registered under the Kerala Act, with the certificate on display
2. Local-body licence and fire clearance in place
3. Biomedical waste authorisation and treatment-facility contract signed
4. Drug sourcing, storage log and emergency kit ready
5. Consent forms, records system and data-protection notice ready
6. GST position confirmed and indemnity insurance active
7. Website and social media checked against the NMC guidelines

At ISHA

The combined fellowship includes a practice-management module on clinic set-up, pricing, staffing, patient-safety protocols and compliant communication, alongside the hair and skin curricula.