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In New Hampshire, Botox injections are considered medical practice and must be administered by a licensed physician, a physician assistant (PA) working under the supervision of a physician, or an independent practice nurse practitioner (NP) if the procedure falls beyond their area of practice. If [1] the physician has performed the examination, evaluation, and documentation regarding the diagnosis and treatment, and [2] the RN or LPN possess the knowledge and training to competently and safely perform the procedure, the physician may delegate Botox injection to a registered nurse (RN) or licensed practical nurse (LPN) under the physician's guidance and supervision..

Similarly, an individual practice NP may delegate Botox injection to an RN or LPN if [1] the procedure is within the scope of the NP's practice, [2] it is done in compliance with nursing delegation regulations, [3] the NP has completed the assessment, evaluation, and documentation for the diagnosis and treatment, and [4] the RN or LPN has the expertise and training to safely and competently conduct the procedure.

The following additional conditions must be met when delegating to an LPN: A) a provider's legal written order B) The client has been reviewed by the provider prior to the treatment. C) In the provider order, the actual drug, dose, and location must be listed. D) The process is being monitored on-site by an approved provider.