Prior to delegating a medical practice or task, the physician shall determine the following:

1. (1) That the medical practice or task is within that physician’s authority to perform;
2. (2) That the medical practice or task is indicated for the patient;
3. (3) The appropriate level of supervision for the physician to exercise while the medical practice or task is being performed;
4. (4) That the person to whom the medical practice or task is being delegated is qualified and properly trained to perform the medical practice or task; and

5. (5) That the medical practice is one that can be appropriately delegated when considering the following factors:

   1. (A) That the medical practice can be performed without requiring the exercise of judgment based on medical knowledge;
   2. (B) That the results of the medical practice are reasonably predictable;
   3. (C) That the medical practice can be safely performed according to exact, unchanging directions;
   4. (D) That the medical practice can be performed without the need for complex observations or critical decisions; and
   5. (E) That the medical practice can be performed without repeated medical assessments.