Contents. The evaluation and treatment protocol shall include the following: Identification, licensure information, and signature of the: Licensed athletic trainer; and Licensed supervising physician; Information about where the athletic trainer practices, including: Addresses of the primary employer and supervising physician; and Identification of the settings where the athletic trainer may practice; Description of the supervision mechanism that applies to each setting; Description of the delegated processes and procedures that the athletic trainer may use in each of the following areas: Injury or illness prevention and wellness; Clinical evaluation and assessment; Immediate and emergency care; Treatment, rehabilitation, and reconditioning; and Organizational and professional well-being; Descriptions of tasks which the athletic trainer may not perform; Description of specialized tasks the supervising physician is delegating to the athletic trainer to perform with documentation of competencies, certification, credentials, or any other requirements established by the Board to support the delegation of the specialized tasks; A statement of whether or not the supervising physician will permit the athletic trainer to accept outside referrals meeting the requirements stated in Regulation .05F of this chapter; If applicable, the name and other relevant information about an alternate supervising physician; and An attestation that states that the supervising physician will be responsible for providing ongoing and immediately available instruction that is adequate to ensure the safety and welfare of a patient and is appropriate to the setting. Process and Approval. A licensed athletic trainer shall: Submit an evaluation and treatment protocol on a form approved by the Board; and Pay the fee as specified in Regulation .08 of this chapter. A licensed athletic trainer may practice athletic training after receiving written approval from the Committee. The Committee shall conditionally approve an evaluation and treatment protocol if: The evaluation and treatment protocol does not include specialized tasks; or The evaluation and treatment protocol includes specialized tasks that have been previously approved by the Board. If an evaluation and treatment protocol includes a specialized task that has not been previously approved by the Board, the athletic trainer may perform the specialized task only after receiving written approval from the Board. After consideration by the Committee, the Board shall either: Approve the evaluation and treatment protocol and any specialized tasks; or Disapprove the evaluation and treatment protocol or a specialized task if the Board determines that the evaluation and treatment protocol or specialized task does not meet the requirements in Health Occupations Article, §14-5D-11.3(b), Annotated Code of Maryland. If the Board disapproves an evaluation and treatment protocol or a specialized task included in an evaluation and treatment protocol, the Board shall send written notice of the disapproval to the: Primary supervising physician; and Athletic trainer. An athletic trainer who receives notice of a disapproval of an evaluation and treatment protocol from the Board shall immediately cease: Practicing under the evaluation and treatment protocol; or Performing the specialized task. An individual member of the Board is not civilly liable for any act or omission relating to the approval, modification, or disapproval of an evaluation and treatment protocol. Termination of Evaluation and Treatment Protocol. If the athletic trainer or the supervising physician terminates the evaluation and treatment protocol, the athletic trainer shall cease practicing until another evaluation and treatment protocol is approved by the Board. The supervising physician shall report the termination of an evaluation and treatment protocol for any reason to the Board within 10 days of the termination and provide the following information: Name and license number of supervising physician and athletic trainer; and Reason for termination, including a description of conduct or incident that resulted in the termination. Emergency Evaluation and Treatment Protocol. In the event of a sudden departure, incapacity, or death of a supervising physician, a designated alternate may assume the role of the supervising physician by submitting a new evaluation and treatment protocol to the Board within 15 days. Dry Needling Protocol. The practice of dry needling by a licensed athletic trainer shall require approval from the Board as a specialized task. The Board shall issue approval to perform dry needling to a licensed athletic trainer who provides proof of completion of at least 80 hours of instruction in a continuing education course approved by: The National Athletic Trainers’ Association; The Board of Certification for the Athletic Trainer; or The United States Armed Forces. Course Requirements. Of the 80 hours of instruction required under §E(2) of this regulation, at least 40 hours of instruction shall be in the following content areas: Theory and application of dry needling; Dry needling technique, including spine and extremities; Dry needling indications and contraindications; Infection control, the Occupational Safety and Health Administration’s Bloodborne Pathogen Protocol, and safe handling of needles; Emergency preparedness and response procedures related to complications associated with dry needling; and Appropriate documentation of dry needling. Of the 80 hours of instruction required under §E(2) of this regulation, at least 40 hours shall be practical, hands-on instruction in the application and technique of dry needling that is completed under the guidance of a licensed health care practitioner who: Is approved to perform dry needling; and Has practiced dry needling for at least 5 years. The instruction required under §E of this regulation shall include an assessment of the licensed athletic trainer’s competency to perform dry needling that is performed by the instructor of the approved course.