1. (1) Prior to utilizing botulinum toxin (commonly known as, among other names, Botox, Vistabel, Dysport, or Neurobloc) for nonsurgical cosmetic procedures, a naturopathic physician shall establish a physician/patient relationship which includes, but is not limited to:

   1. (a) Taking a history;
   2. (b) Performing an appropriate physical examination;
   3. (c) Making an appropriate diagnosis;
   4. (d) Recommending appropriate treatment;
   5. (e) Obtaining the patient's informed consent;
   6. (f) Providing instructions for emergency and follow-up care; and
   7. (g) Preparing an appropriate medical record.

2. (2) The naturopathic physician is responsible for:

   1. (a) The safety of the patient;
   2. (b) Performing the nonsurgical cosmetic procedure in accordance with standard medical practice; and
   3. (c) Ensuring that each treatment is documented in the patient's medical record.

3. (3) Prior to being allowed to prescribe and administer botulinum toxins for cosmetic purposes, naturopathic physicians must be appropriately trained in aesthetic injectable techniques. Such training must be a combination of hands-on training and training in pharmacology that pertains to aesthetics and must also include:

   1. (a) Criteria for the selection and treatment of patients;
   2. (b) Indications and contraindications for each procedure;
   3. (c) Preprocedural and postprocedural care;
   4. (d) Recognition and acute management of potential complications; and
   5. (e) Infectious disease control.

[Statutory Authority: RCW 18.36A.160. WSR 23-23-077, § 246-836-212, filed 11/13/23, effective 12/14/23.]