The written practice agreement required pursuant to NRS 631.3122 between the authorizing dentist and a dental therapist must include: 1. The services and procedures and the practice settings for those services and procedures that the dental therapist may provide, together with any limitations on those services and procedures. 2. Any age-specific and procedure-specific practice protocols, including case selection criteria, assessment guidelines and imaging frequency. 3. Procedures to be used with patients treated by the dental therapist for informed consent and creating and maintaining dental records. 4. A plan for the monthly review of patient records by the authorizing dentist and dental therapist. 5. A plan for managing medical emergencies in each practice setting in which the dental therapist provides care. 6. A quality assurance plan for monitoring care, including patient care review, referral follow-up, and a quality assurance and chart review. 7. Protocols for administering and dispensing medications, including the specific circumstances under which medications may be administered and dispensed. 8. Criteria for providing care to patients with specific medical conditions or complex medical histories, including requirements for consultation before initiating care. 9. Specific written protocols, including a plan for providing clinical resources and referrals, governing situations in which the patient requires treatment that exceeds the dental therapists capabilities or the scope of practice as a dental therapist. 10. A requirement that when an appointment is made for a patient, it must be disclosed to the patient whether the patient is scheduled to see the dentist or a dental therapist.
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