Jurisdiction Verification

Every Scope & Standard document includes this page. It is published here free because it contains no law, only the questions and who answers them.

Practice location (state): ______

Verify each item with the body named before any framework document is used. Record the date and the source.

• Who may perform each procedure, under what delegation or supervision. Board of Nursing, Board of Medicine.
• Whether a prescriber evaluation is required before treatment, whether telehealth satisfies it, how long it stays valid.
• Whether standing orders are permitted for these services, or patient-specific orders are required.
• Supervision level required: on-site, available, or independent.
• Ownership and corporate practice rules affecting this practice.
• Record retention period and patient access rules.
• Compounded and prescription product sourcing rules. Board of Pharmacy.
• Esthetician versus medical scope boundary. Board of Cosmetology.
• Mobile or offsite service rules, if applicable.
• Adverse event and regulatory reporting obligations.
• Emergency equipment or medication requirements for this setting.

Verified by: ______ Title: ______ Date: ______ Accountable prescriber: ______ Signature: ______ License #: ______ Next verification due: ______

The State Requirements Worksheet expands this page into a full verification trail: a where-to-verify directory, a scope and delegation profile, an oversight page, a mobile page, a records page, and a state changes log. It is in the shop.