Medical aesthetics is regulated by professional colleges, province by province, so the rules a nurse injector works under in Toronto differ from those in Vancouver, Calgary or Montréal. This is where four provinces stand as of October 7, 2026. Where we rely on law-firm commentary rather than a college’s own page, we say so.
Ontario: new guideline, directive change proposed
The College of Nurses of Ontario published its Aesthetic Services guideline on July 3, 2026, and is reviewing how medical directives and delegation are used in aesthetics. The CNO is considering making client-specific orders the only mechanism. Consultation closed in July and Council was scheduled to meet on September 23 and 24. The CNO has told CBC that a plan of care could continue without a new assessment at every visit while the client’s condition and goals stay the same. We found no published decision yet. Full detail in our Ontario item.
British Columbia: client-specific orders are already required
BCCNM’s guidance for registered nurses (page updated June 11, 2026) is direct:
- A client-specific order is required for procedures involving an injectable drug or substance or an implantable device, including thread-lift sutures.
- Nurses (RNs, LPNs, RPNs, certified nurses) cannot give orders for medical aesthetic procedures. An authorized health professional must.
- The ordering professional must be present at the facility and immediately available for consultation while the nurse administers the injectable.
Fasken adds that the standards for nurses acting under client-specific orders became part of the BCCNM bylaws in April 2026. In other words, BC already works on roughly the model Ontario is considering.
Alberta: client-specific orders, no standing orders
The College of Registered Nurses of Alberta (CRNA) published practice advice on injectable cosmetic therapies on December 12, 2025. It says:
- Schedule 1 drugs such as neuromodulators need a client-specific order from an authorized prescriber (a physician, NP or dentist). RNs cannot prescribe them.
- Standing orders (orders that are not client-specific) “must never be used”.
- If the client’s condition no longer supports the prescribed treatment, or the plan changes (a new injection site or a dose adjustment), the nurse must refer back to the prescriber and get updated orders first.
- Dermal fillers are regulated as medical devices. The product needs a Health Canada medical device licence and a vendor with a Medical Device Establishment Licence. The CRNA recommends fillers be given under a client-specific order too.
- Nurses must have reasonable access to the prescriber for consultation in an adverse event or urgent situation.
- Advertising may not include endorsements or testimonials about products, services or results, or inducements such as limited-time offers or discount coupons.
One difference to note: Fasken describes Alberta as requiring the prescriber to stay in close proximity during the injection. The CRNA document we read says “reasonable access” for consultation. Check the current wording with the CRNA before you rely on either.
Fasken also notes that since February 1, 2025 the Alberta College of Pharmacy has prohibited pharmacists and pharmacy technicians from giving aesthetic injections as regulated members. We have not checked that against the college’s own page.
Quebec: four orders working together
On November 28, 2025 the Collège des médecins du Québec, the Ordre des dentistes du Québec, the Ordre des infirmières et infirmiers du Québec and the Ordre des infirmières et infirmiers auxiliaires du Québec announced a joint initiative on medical-aesthetic care. The work is planned for 2026, and a practice guide could result. We have not seen the output yet. Fasken reports Quebec also requires a client-specific order and a nearby prescriber; we have not checked that against a Quebec order’s own guidance.
What it means for a clinic
- The direction is the same everywhere. Fasken’s summary is that regulators treat cosmetic injectables as prescription-based medical acts and are moving toward closer prescriber involvement.
- Prescriber access matters. BC requires the ordering professional to be at the facility (BCCNM). Alberta requires reasonable access for consultation (CRNA). Fasken reports Quebec expects a nearby prescriber.
- Build records that show who ordered, who treated and what was used.
- Multi-province operators should not assume one standard. Keep a per-province checklist.
- Check the primary source before you act. College pages change; this roundup is a pointer, not a substitute.
We will update this item as Ontario’s Council and Quebec’s orders publish outcomes.
This is general information, not legal advice.