Across most of Canada, a registered nurse can provide cosmetic injectables under a Medical Director or Nurse Practitioner who is not physically in the room, as long as every client gets a genuine assessment and a client-specific order. The two exceptions are British Columbia and Quebec, where the prescriber has to be on-site. Manitoba and New Brunswick work with conditions. Here is the whole country on one page.
This is general information, not regulatory advice. We checked each province's physician and nursing college standards in August 2026. Standards change, and your own college is the only authority on what applies to you. Confirm with it before you rely on anything here.
The short answer
| Province | Remote prescriber? | The condition that matters | Colleges |
|---|---|---|---|
| Ontario | Yes | Orders from a physician or NP, and a client-specific order for every client | CPSO, CNO |
| Alberta | Yes | A client-specific order for every client | CPSA, CRNA |
| Saskatchewan | Yes | Standards are being revised, re-check before you commit | CPSS, CRNS |
| Manitoba | NP only | A physician cannot be Medical Director of a clinic they do not practise in | CPSM, CRNM |
| Nova Scotia | Yes | A client-specific order for every client | CPSNS, NSCN |
| New Brunswick | Conditional | The prescriber should be available for on-site assessment, ask NANB | CPSNB, NANB |
| Prince Edward Island | Yes | A client-specific order for every client | CPSPEI and the provincial nursing regulator |
| Newfoundland and Labrador | Yes | A client-specific order for every client | CPSNL and the provincial nursing regulator |
| British Columbia | No | The prescriber must be present in the facility during the procedure | CPSBC, BCCNM |
| Quebec | No | A physician on-site near the patient, and an individual order for each patient | CMQ, OIIQ |
Two rules that apply in every province
Every client needs a real assessment and a client-specific order. Neuromodulators such as botulinum toxin are prescription drugs. A standing order, or a medical directive with nobody assessing the individual client, does not meet that anywhere in Canada. Where a remote prescriber is allowed, the assessment can happen by telehealth, but it has to happen.
Nurse Practitioners are the most portable prescribers. In most provinces an NP can act as the authorizing prescriber for an aesthetic nursing practice, within their scope and competence. In Manitoba an NP is the only remote option. If your practice might ever cross a provincial line, an NP relationship travels furthest.
Where remote oversight works
Ontario is where the model is most established: an RN or RPN works under orders from a physician or NP who does not have to be on the premises. Our complete Ontario guide covers it in detail, along with the RN, RPN and NP specifics.
Alberta, Nova Scotia, Prince Edward Island, and Newfoundland and Labrador work the same way in principle: a remote physician or NP, and a client-specific order for every client. Saskatchewan does too, but its standards are being revised, so check the current version with the CRNS and CPSS before you sign an arrangement.
Manitoba and New Brunswick: yes, with conditions
Manitoba. Under CPSM rules a physician cannot be the Medical Director of a clinic they do not practise in. A remote arrangement in Manitoba therefore runs through a Nurse Practitioner authorizer, which is how we match practices there.
New Brunswick. NANB guidance expects the authorizing prescriber to be available for an on-site assessment when one is needed. How that applies to a prescriber based elsewhere in the province is not spelled out, so ask NANB before you set up a remote arrangement.
British Columbia and Quebec: why we do not offer it
British Columbia. BCCNM's standards for both RNs and LPNs require the prescriber to be present in the facility during the procedure. A remote Medical Director does not fit that, however the arrangement is documented.
Quebec is stricter still. The physician must be on-site, close to the patient, and each patient needs an individual order. Collective orders are not an accepted route for this work.
If you practise in either province, the answer is an on-site prescriber. We do not match there, because we could not stand behind the arrangement.
What this means for you
If you are an injector, start with your province: Alberta, Saskatchewan, Manitoba, Nova Scotia, New Brunswick, Prince Edward Island and Newfoundland and Labrador, or the Ontario guide. Before you sign with anyone, run them through the vetting checklist.
If you are a physician or NP with aesthetics experience, practices outside Ontario are looking for qualified medical direction now, and founding directors in a new province get first pick of the practices there.
One request, verified prescribers.
Tell us your province and what you offer. We check every prescriber against their college and introduce only the ones who fit. Free for injectors.
Get matched, free Join the networkCommon questions
Can a nurse inject Botox without a doctor on-site in Canada?
In most provinces, yes, if a physician or Nurse Practitioner has assessed the client, often by telehealth, and issued a client-specific order. British Columbia and Quebec are the exceptions: there, the prescriber must be on-site during the procedure.
Which provinces allow a remote Medical Director for nurse injectors?
Ontario, Alberta, Saskatchewan, Nova Scotia, Prince Edward Island, and Newfoundland and Labrador, with a client-specific order for every client. Manitoba allows it through a Nurse Practitioner authorizer, and New Brunswick expects the prescriber to be available for on-site assessment. British Columbia and Quebec do not allow it.
Can a Nurse Practitioner be the Medical Director for a med spa?
In most provinces an NP can act as the authorizing prescriber for an aesthetic nursing practice, within their scope and competence. In Manitoba an NP is the only remote option. Confirm the specifics with your provincial nursing college.
Is a medical directive enough on its own?
Not for prescription products. A directive can set out who does what and how, but each client still needs a genuine assessment and a client-specific order from a physician or NP, in every province.
General information for Canadian healthcare professionals, checked against provincial college standards in August 2026. Not medical, legal, regulatory, or compliance advice. Botox® is a registered trademark of its owner; Plus One MD is not affiliated with or endorsed by any drug manufacturer or regulatory college. Confirm current requirements with your own college and qualified advisors.