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In Delaware, Botox injections are considered medical practice and must be performed by physicians; independent practice nurse practitioners (NP) if the procedure is within their scope of practice and they are working within their role and population focus (NPs who have completed at least 2 years and 4,000 full-time hours of practice under a collaborative practice agreement with a physician) (PA), under physician supervision and written supervision agreement; or any other non-physician, under appropriate physician delegation and supervision if [1] it falls within their scope of practice, [2] they have the knowledge, training, and skill to safely and competently perform the procedure, and [3] they are not prohibited from performing the procedure by statute or professional regulation.

An unaffiliated activity If [1] it falls within the NP's scope of practice, position, and population focus [2] it is pursuant to the nursing delegation rules, and [3] the RN and LPN have the education, ability, and training to safely and competently perform the procedure and if it falls within the RN and LPN's scope of practice, an NP in Delaware can delegate Botox injection to an RN or LPN.