August 12, 2026 · 9 min read

12 Things to Check Before You Sign a Commercial Lease for a Clinic

Signing a commercial lease for a clinic is one of the biggest decisions a dentist, physician or pharmacy owner will make, and most of the costly surprises show up after the ink is dry — during buildout, not before. We have walked into more than one space where the landlord assured everyone it was move-in ready for a dental practice, only to find the electrical panel had no spare capacity and the plumbing stack was three units away from where the operatories needed to go.

Key takeaway. A commercial lease for a clinic needs to be evaluated on more than rent and location. The base building's electrical capacity, plumbing layout, structural support, and the landlord's approval process for your buildout plans determine whether your fit-out is straightforward or a six-figure surprise. Get a contractor to walk the space before you sign, not after.

The 12 Things to Verify

1. Tenant improvement allowance — and what it actually covers

Landlords often advertise an allowance per square foot, but the number means little until you know what it covers. Does it apply to base building upgrades — electrical service, plumbing rough-in — or only cosmetic interior work? Is it paid upfront, on completion, or reimbursed in draws? Get it in writing and have a contractor estimate your actual buildout cost against it. We have seen allowances cover less than a third of what a clinic fit-out actually requires. There is more detail in our tenant improvement allowance guide.

2. Base building electrical capacity

Dental and medical equipment — imaging, sterilization units, compressors, multiple operatory chairs — draws significantly more power than typical office tenants. Confirm the amperage available to the unit and whether the existing service and panel have spare capacity, or whether an upgrade is needed, which can mean coordinating with the utility and other tenants. This single item has derailed more clinic buildout timelines than almost anything else.

3. Plumbing capacity and stack location

Every dental chair and most medical exam rooms need water supply and drainage. Check where the building's plumbing stacks sit relative to your proposed floor plan — moving plumbing across a unit is expensive and sometimes structurally difficult in a concrete slab building. Ask specifically whether the space has ever housed a clinical tenant; if not, assume you are starting from zero.

4. HVAC capacity and ventilation requirements

Clinics have ventilation and air-exchange requirements that differ from general office use, especially around sterilization and treatment areas. Confirm the existing system's capacity and whether it can be zoned or modified for clinical requirements without a full replacement.

5. Zoning and permitted use for medical or dental purposes

Confirm in writing, from the municipality rather than verbally from the landlord or leasing agent, that zoning permits medical or dental clinic use. Some commercial and mixed-use zones restrict healthcare uses or require a specific permit process. Check this before you sign, not during permitting.

6. The landlord's approval process for buildout plans

Every lease should spell out how buildout plans get approved: what the landlord needs to see, how long they have to respond, and what happens if they request changes. A vague or slow approval process can add months before construction even starts. Push for defined response timelines in the lease itself.

7. Structural support for equipment

Heavy equipment — imaging machines, sterilization autoclaves, some specialty dental chairs — can require reinforced flooring or specific structural support, especially above ground floor. Confirm floor loading capacity for your proposed layout.

8. Accessibility and code compliance for clinical use

Confirm the space meets current accessibility requirements for a healthcare tenant, including corridor widths, washroom accessibility and door clearances. These can be stricter than they were for the previous tenant's use, and retrofitting them is expensive.

9. Parking and patient accessibility

Clinics generally need more accessible, convenient parking than a typical office tenant — patients recovering from procedures, elderly patients, and parents with children all need easy access. Confirm dedicated or sufficient parking is included in the lease, not just "available in the building".

10. Exclusivity and use-restriction clauses

Check whether the lease includes an exclusivity clause protecting you from a competing practice in the same building or plaza, and equally whether existing clauses held by other tenants restrict your intended services. Both directions matter.

11. Signage and visibility rights

Patients need to be able to find you. Confirm what signage rights the lease grants — exterior, building directory, window — and whether those rights require separate landlord or municipal approval.

12. Renewal terms and buildout amortization

Clinic buildouts are expensive and not easily portable. Confirm the lease term is long enough to amortise your investment, and check renewal terms and rent escalation clauses now, before you have sunk six figures into a fit-out you cannot easily walk away from.

Quick Reference

Why CSA Z8000 Belongs in Your Lease Review

A dental or medical fit-out in BC needs to meet CSA Z8000 requirements for health care facility planning and design — infection control, ventilation, room layout and finishes. That is not only a construction-phase concern; it should shape which spaces you even consider leasing. A space whose plumbing and HVAC sit far from what compliant clinical rooms require will cost significantly more to bring up to standard.

A Note on Scope

This checklist is written from a construction and buildout perspective — what we, as contractors, wish every clinic owner checked before signing. It is not legal advice. Have your lease reviewed by a commercial real estate lawyer and, ideally, a broker experienced in healthcare tenancies, alongside the construction due diligence above.

Frequently Asked Questions

What should a dentist or doctor check before signing a commercial lease? Beyond rent and location, check the tenant improvement allowance's actual scope, the base building's electrical and plumbing capacity for clinical equipment, zoning permission for medical use, and the landlord's process for approving buildout plans. These determine your real buildout cost and timeline far more than the lease rate does.

What is a tenant improvement allowance and is it enough for a clinic buildout? A tenant improvement allowance is money a landlord contributes toward fitting out the space, usually quoted per square foot. For clinical buildouts it is frequently not enough to cover the electrical, plumbing and specialized construction a dental or medical space requires, so get a contractor's estimate before assuming it covers your project.

Does a commercial space need special zoning for a medical or dental clinic? Yes, in most BC municipalities medical and dental uses require zoning that specifically permits healthcare use, and this varies by zone and municipality. Confirm it directly with the municipality in writing before signing, not solely on the landlord's representation.

Why does electrical capacity matter so much for a clinic lease? Clinical equipment — imaging, sterilization units, compressors and multiple treatment rooms — draws considerably more power than typical office tenants use, and upgrading a building's electrical service after signing can be slow and expensive. Verifying spare capacity before signing avoids a major buildout delay.

Should I hire a contractor before signing a clinic lease, or after? Before. A contractor can walk the space and flag electrical, plumbing, structural and zoning issues that directly affect your buildout cost and timeline — information that should inform your lease negotiation rather than surface after you are already committed.

Do I still need a lawyer if I use a clinic lease checklist like this one? Yes. This checklist covers the construction and buildout issues that affect fit-out cost and timeline. Lease terms, liability and legal obligations still need review by a commercial real estate lawyer, and ideally a broker experienced in healthcare tenancies.

Conclusion

A commercial lease for a clinic is a construction decision as much as a legal and financial one — the base building's condition and the landlord's buildout process shape your costs and timeline more than almost anything else in the lease. Working through this checklist before you sign, and getting a contractor's eyes on the space early, is the difference between a smooth fit-out and a project that runs over budget before it starts.