Who can inject
MD, DO, NP, PA, RN under physician supervision/delegation
Registered nurses (RNs)
Yes, under physician delegation; scope includes neurotoxins and fillers with documented supervision
Nurse practitioners & physician assistants
NP/PA may inject under physician collaboration; independent practice scope limited
The exam that makes it legal
Required; in-person or telehealth permitted A valid order or good-faith exam by an authorized provider is what makes an injection lawful — not simply who holds the syringe.
Training expected
No state-mandated injector training beyond licensure.
What to verify in Hawaii
Verify current RN delegation scope with Hawaii Medical Board and ensure physician supervision agreements are in writing.
Primary source: Hawaii Medical Board
General business information for Hawaii medical-spa owners, current as of 2026 — not legal advice. State boards update rules often; confirm specifics with the Hawaii board (and your own counsel) before you act.