Practice Agreement · RN
Registered Nurse Practice Agreement in Ohio
Ohio law does not require a Registered Nurse to hold a named agreement with a physician. Practices still use one to define the working relationship; here is what it covers and what the state does require.
FULL for general nursing scope (Ohio Rev. Code §4723.01(B)) — confirmed directly via the Ohio Board of Nursing's official scope-of-practice document: physician supervision is NOT required for general RN practice. SUPERVISED_ONLY carve-out for physician-delegated medical-aesthetic procedures — injectables and laser HAIR REMOVAL are two separately-regulated tracks detailed below; general non-ablative vascular-laser delegation for other purposes appears to sit under a separate, unconfirmed rule.
What a Registered Nurse practice agreement covers in Ohio
Governed by the Ohio Board of Nursing. Each numbered item is a statutory requirement the agreement must satisfy.
The Registered Nurse ("RN") shall practice under the orders, standing orders, or delegation of the Physician, consistent with the Ohio Nurse Practice Act, Ohio Rev. Code Chapter 4723. Unlike the Standard Care Arrangement required of Advanced Practice Registered Nurses, Ohio law does not require a collaboration agreement for this Registered Nurse's general scope of practice; the Physician shall instead be available to the Registered Nurse for consultation regarding clinical and patient care issues arising under any order or delegation.
- The agreement on file also carries 2 scope, 2 education, 2 registration clauses, generated in the document itself.
Statutes and rules cited
- Ohio Rev. Code § 4729.39statute
Authorizes a pharmacist to manage drug therapy under a written consult agreement with a physician (or a PA/APRN authorized by a physician).
- Ohio Admin. Code 4729:1-6-02regulation
Required contents, duration, and recordkeeping for a pharmacist consult agreement.
Terms it has to carry
Ratio, proximity, chart review, meeting and prescribing terms the agreement has to carry, from the state's supervision rules.
Proximity
physician-delegated LASER HAIR REMOVAL specifically (Ohio Rev. Code §4731.33) — CURRENT LAW as of 2026-08-14; H.B. 377 changes this eff. 8/25/2026, see module docstring: On-site presence required
OAC Ch. 4731-18 (current version, in effect since 4/30/2023): the delegating physician must provide ON-SITE supervision, defined as the same office suite (not necessarily the same room). The physician must personally evaluate the patient before initial treatment and again after the initial application before continuing. H.B. 377 (signed 5/27/2026, eff. 8/25/2026 — NOT YET LAW) will permit OFF-SITE supervision where the nurse has completed a 40-hour board-approved training course, and will narrow the pre/post-evaluation requirement so it no longer applies to nurse delegates. Re-verify and update this entry once that date passes. NARROWED SCOPE (found in a follow-up pass): H.B. 377 amends §4731.33, the HAIR-REMOVAL-specific statute, only — general non-ablative vascular-laser delegation for other purposes (vascular lesions, tattoo removal, skin resurfacing) is governed by a separate provision, OAC 4731-18-03(A), which appears to remain an unchanged 2-person/on-site rule; this separate track was not independently confirmed to a high confidence level and should be checked directly if it matters for a specific use case.
Supervision ratio
physician-delegated LASER HAIR REMOVAL specifically (Ohio Rev. Code §4731.33) — CURRENT LAW as of 2026-08-14; H.B. 377 raises this to 5 eff. 8/25/2026: Up to 2 at a time
A physician may supervise no more than 2 persons at a time for laser-hair-removal delegation under current law. Rises to 5 once H.B. 377 takes effect 8/25/2026 — see module docstring. The precise pre-H.B.-377 statutory location of this '2' figure carries some uncertainty — one older secondary source suggested the hair-removal statute historically had no numerical ratio at all — but the 2→5 CHANGE itself is well corroborated across independent sources.
Chart review
Not codified — left to the agreement
Meeting cadence
Not codified — left to the agreement
Prescriptive authority
Covered by the practice agreement · no controlled-substance authority
Confirmed: general RNs (non-APRN) have no independent prescriptive authority — reserved to APRNs (CNP/CNS/CNM/CRNA) under Ohio Rev. Code §4723.48 and related sections.
Written agreement
Not required
Unconditional for general nursing practice. For cosmetic injectables (Botox/fillers), an Ohio Board of Nursing interpretive guideline requires a documented medical evaluation, established medical regimen, and a valid order from a provider with cosmetic/aesthetic competency — but no codified on-site/off-site PROXIMITY standard for the ordering physician was found either way (distinct from the laser rule below, which does codify one); treat this as a genuine gap, not a confirmed telecommunication-sufficient standard. For laser/light-based device delegation, see the codified Medical Board rule in supervision.proximity below.
Practice ownership (corporate practice of medicine)
Non-licensee ownership permitted — Same no-CPOM-doctrine framework as `pa` (Ohio Rev. Code §4731.226) — an RN may generally own a med-spa business entity, provided the medical-scope portion retains a licensed physician as medical director.
Legal sources for these rules (7)
- Ohio Rev. Code §4723.01(B) — RN scope of practice
- Ohio Board of Nursing — 'Scopes of Practice: RNs and LPNs' (Nov. 2025, official, read directly)
- Ohio Rev. Code §4731.33 — Laser hair removal delegation, specifically amended by H.B. 377 (via Cornell LII mirror and law-firm secondary sources describing the 4/30/2023 rule version)
- OAC 4731-18-03(A) — General non-ablative vascular-laser delegation (a separate, apparently H.B.-377-unaffected track — not independently confirmed to a high confidence level, flagged in a follow-up pass)
- H.B. 377, signed 5/27/2026, eff. 8/25/2026 — raises laser-HAIR-REMOVAL-delegation ratio to 5, permits off-site supervision with training; NOT YET LAW as of this file's date; confirmed via Mondaq legal alert in a follow-up passsecondary
- Ohio Board of Nursing interpretive guideline — 'Cosmetic/Aesthetic Patients Receiving Intramuscular, Subdermal, or Subcutaneously Injected Medications' (title/existence confirmed; full text 404'd on direct fetch, summarized via search snippet only)
- Ohio Rev. Code §4731.226 — Authorized business-entity forms (CPOM)
About Ohio's rules
Ohio recently relaxed CRNA supervision from 'immediate presence' to facility-wide 'collaboration' (H.B. 52, eff. 6/8/2026, now current law), and will loosen RN laser-delegation rules similarly (H.B. 377, eff. 8/25/2026 — NOT yet law as of this file's date). No independent-practice pathway exists for NP/PMHNP/PA despite active pending reform bills (a 2,000-hour NP threshold, PA proximity removal) — none enacted. Ohio has no corporate-practice-of-medicine doctrine (State Medical Board, 2012). Non-nurse midwifery has no current licensure pathway.
Other clinicians in Ohio: see the state overview.