A board or commission shall refer a decision or action to the Office as required by Health Occupations Article, §1-203, Annotated Code of Maryland, and this chapter. Boards and commissions may not refer decisions or actions that consist of the following: Ministerial acts; The internal operations of a board or commission; Investigations; Disciplinary charges that have not led to proposed disciplinary action; and As it relates to an individual regulated by a board or commission: Consent orders; and Letters of surrender. A board or commission may initiate a referral to the Office by transmitting a form substantially similar to that in Appendix A of this chapter. A board or commission may request expedited review by the Office by including the phrase “EXPEDITED REVIEW REQUESTED” on the transmittal form. A request for expedited review by the Office shall be granted if: The board or commission establishes that immediate action is necessary to protect public health and safety; The decision or action involves a cease and desist order; or The decision or action of the board or commission involves the summary suspension of a license. The board or commission may withdraw the referral to the Office at any time before the decision is issued. Computation of time is governed by COMAR 28.02.01.04C.