ATTN: All injections of bioactive agents (botox, etc.), regardless of purpose, must have a physician delegation.

Licensed Practical Nurses,

The CLPNS is clarifying information previously provided in our practice guidance related to LPNs administering injections of bioactive agents (BOTOX®, etc.).

LPNs must have a delegation from a physician to inject bioactive agents in all circumstances and for all reasons. 

LPNs may only accept a delegation to inject bioactive agents:

  1. from a duly qualified medical practitioner (physician), and
  2. only after the physician has first assessed the client and established a treatment plan.

It came to our attention that CLPNS incorrectly advised some LPNs that a delegation was only required when the injection was for medical purposes like migraines or hyperhidrosis and not needed if it was for cosmetic aesthetics only. This is incorrect.

Do not engage in or further engage in the practice of injecting bioactive agents if you are an LPN who does not have a delegation to do so by a duly qualified physician who has assessed the client and established the treatment plan. 

Remember, there are requirements for both the physician and the LPN related to the delegation of these injections. LPNs and Physicians are accountable to practice according to the requirements outlined in the respective bylaws.

We apologize for the miscommunication and inconvenience. Please contact the CLPNS for further information and guidance.

Questions? Please email

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