The Ultimate Solo Practice Startup Checklist

This solo practice startup checklist walks U.S. therapists through setup in the order that protects you: legal registration first, then HIPAA paperwork, then money systems, then the work of getting found. Each step exists because skipping it creates a problem that is expensive or impossible to fix later.

Going solo also means becoming the marketing department, the compliance officer, and the accountant on the same day. Grad school trained you for the clinical work; the business infrastructure it skipped is what this checklist supplies.

The legal foundation

Before you book that first private client, lock down your professional identity.

Keep your state license current and in good standing with your specific board.
Carry professional liability insurance from day one. Call your provider and confirm they know you are now flying solo.
Get an NPI (National Provider Identifier). If you just left an agency, you probably already have a Type 1 NPI; if not, register through the CMS NPPES system [2].
Apply for an EIN (Employer Identification Number), which works like a social security number for your business. You need it to open a business bank account, and the IRS issues it free [3].
Choose your business structure. Deciding between a sole proprietorship and an LLC is a major legal move; we covered why an LLC is usually the safer bet for protecting personal assets in a previous article.

Compliance and paperwork

Get your legal house in order so your clinical work is protected from minute one.

Draft intake forms that are clear and board-compliant: limits of confidentiality, cancellation policies, social media rules, and emergency protocols [4].
Write your HIPAA policies for managing and protecting Protected Health Information (PHI) [5].
Collect signed Business Associate Agreements (BAAs) from every vendor whose tools might touch patient data, including email, calendar, and EHR. No exceptions [5].

The money

Clinical work and a healthy bank account cannot be separated. Set up your financial infrastructure properly from the start.

Open a business bank account. Never mix personal and business money; take your new EIN to the bank and open a dedicated checking account.
Set your rates. Figure out a full fee that honors your education and experience, and factor in solo overhead such as software, retirement, and self-employment taxes.
Choose a payment processor. Most therapists use a merchant service like Stripe or Square, or the processor built into their EHR.
Select your EHR. This is where your clinical notes will live, so read up on data ownership before you trap yourself in a permanent software rent subscription.

Getting found

You cannot help people if they do not know you exist.

Set up professional communications: a HIPAA-compliant email address, like Google Workspace with a BAA, and a professional VOIP phone number. Stop giving clients your personal cell.
Buy your domain name now, even if the website itself is six months away.
Build your directory profiles. For most brand-new practices, a solid Psychology Today profile is the main pipeline for early referrals.
Start networking. Email a handful of allied health professionals, including primary care doctors, psychiatrists, and established therapists who are completely full. Introduce your niche and let them know you have openings.

Building on the checklist

The administrative work in a solo practice startup checklist serves a larger purpose: a practice that sustains you for decades. Pace yourself. The work you do is profoundly important, so protect your energy, secure your legal footing, and guard your revenue.

Printable version of this checklist

Starting a practice is stressful enough without constantly trying to dig up this article. If you want help thinking through the operational side of your practice, contact us here. We can also point you to the other guides and tools we are building for solo therapists.