I'm an NP in North Carolina - at my medical spa our estheticians / cosmetologists are allowed to perform laser hair removal and photofacials / laser skin rejuvenation with Aesthera. Is that legal? All the other med spas in the area have their NPs, PAs, nurses, or physicians do it. Thanks!

NCNP
I am not familiar with NC law but you must be very careful. Most state laws and/or medical board rules and regulations define the operation and use of Light Based Medical Devices (which includes all lasers) as the practice of medicine and further limits to whom and under what circumstances the physician can delegate that operation and use, if at all. If the physician can delegate then to whom and does the physician have to be on-site?

Hopefully someone on this site from NC can give you a more definitive answer. You may want to consult with a local attorney or get an opinion letter from the local board(s).

NCNP: You can usually pull up the section of your state laws governing the state medical board on the Internet. Check the definition of the "practice of medicine" as it generally includes operating lasers and IPL systems as one of the actions which constitute the "practice of medicine". Then you will usually find exceptions to the rule which may allow others (i.e, nurses, PAs, etc.) to also operate lasers but possibly under the supervision of a physician. I have found very few states which allow estheticians (non-medical personnel) to perform "laser surgery". Consider engaging local counsel to help you with this-- you need to make sure you are not subjecting your employees to liability (which in some states can be large fines, etc.). It happened to me in Minnesota and it was very embarrassing.

NCNP
I also work in NC in a med spa. According to NC Med Board, they consider laser hair removal as laser surgery (page 17,Forum, No 6 2006 issue). I spoke extensively with the PA that sits on the med board and was assured that the board considers it "surgery". Because of such the only providers allowed to do "laser surgery" are MD's, PA,s and NP's. If you are allowing others to perform the procedure you may be at risk for formal action by the board (if they inspected you). You can contact the PA on the med board and they are very helpful and will answer your questions. Hope this helps.

anyone at burger king can do laser hair removal. these discussions are so outrageous ! go ahead do whatever you want, any laser companies will sell it to you. make money, money have your friends come in and do some treatments, eat some botox, inject mesotherapy,.....

whatever,

Do I sense a little sarcasm?

This same issue is not clear in the state of New Jersey. There is no written law (at least nobody can provide me with written information) regarding the use of IPL and Estheticians performing the treatments in medical offices and medical spas. This however is more disturbing when you see hair dressers performing the treatments in "medical spas" when the physician associated with the spa is never on site.

I know a physician in NJ who has his receptionist perform hair reduction treatmetns and Photofacials and she knows nothing about skin at all.

It is really disturbing, especially when some of us go out of our way to be well educated in our fied.

S. Mace: Several years ago the medical board in N.J. proposed a new definition of "LASER" which -- paradoxically -- included broadband devices as well. In looking at the 2006 statutes/regs which you can find with a Google search I came across the definition of the "practice of medicine" which appears to be another paradoxical mumbo jumbo including the vague term "electromagnetic radiation". It appears that the medical board in New Jersey considers using ANY light technology device to be the "practice of medicine". I am sure a lot of people are currently flying "under the radar" in N.J. as they are in many other states including my home state of Minnesota.

I am a registered nurse. Can I do laser hair removal by myself, in my own spa, without doctor's supervison? Is it legal in California?

cj,

NO. medical board of california requires that a medical spa MUST be owned at least 51% by a physician. He/She the physician MUST see each and every patient , be evaluated before any procedure is done. It is illegal to perform medical procedures without a physician. Check with the medical board PLEASE..... or let me know who you are so I can report you.

To "noway"
I would like to get in touch with you. I live in CA. I would like to get information. Do you have an e-mail?

NOWAY-- Do you have the citation for the regulation which requires that the M.D. must evaluate the patient before the procedure is done in California? This is the first time I have seen this requirement. I know that many other states also have this requirement. Thank-you.

Hi,

Can a Chiropractor perform IPL or laser treatments in Illinois?

Chiropractors are licensed as physicians to treat human ailments, without the use of prescription drugs or surgery.

DC in IL,

Please read the post I placed in reference to FL. You can do it in FL and I feel pretty good in reference to IL. Like always consult a Healthcare Attorney and good luck finding one that actually knows something. I would not waist any more of your time asking web sites for advice. Case in point: Refer to the post prior to mine, it is evidence that plenty of people do not know what they are talking about and still feel justified in acting as they do.

Whatever,

Did I work for you? lol I believe MR. whatever is a little sore because he faces what, 68 FELONIES at the present time for being a cosmetologist doing MESOTHERAPY, LAZOR hair removal, photo facials, inappropriately exposing clients bodies ect ect..sleeping with patients and employees, tax fraud, made front page news in Cleveland , Even US NEWS and world report.....check out www.newsnet5.com investigations,Everybody.....

Hope you ROT in Jail loser!..

Can anyone bring me up to speed on the latest regs in FL? Who can do which procedures (IPL, laser, microderm, etc.)? I have heard about changes but haven't seen anything specific in writing. Can a GP open a medspa? What about a DC?

I agree that each patient should be evaluated by a physician, nurse practitioner or physician assistan licensed to practice.

Anyone know what the restrictions are in TN? Trying to find out all the procedures a lic. esthetician would be allowed to perform in thier own "clinic" or day/med spa???

CS: You need to download and print out the 2007 Florida statute pertaining to the use and delegation of medical lasers and light-based services. You can find it with Google. You are looking for Chapter 458.348 of Section 348 of the Florida statutes. It is very complex and hard to understand but it will tell you what you need to know.

TN-- Check the Tennessee statutes-- look in paticular for the state's definition of "the practice of medicine". Most states have ruled that the operation of lasers constitutes the practice of medicine. Then they usually allow the physician to delegate in certain circumstances. Typically delegation is restricted to licensed medical personnel whose own regulatory board permits-- supervision, standing orders and written/signed protocols are typically required.

First time on this site. I'm a family practitioner with CANP employed by me. I am about to introduce botox, laser hair removal,photorejuvenation into my existing practice part time. I'm also in discussion with a salon/spa owner to add my services to her existing place of business. The idea would be to also have my NP join me there to perform cosmetic services if the client base is there. I'm in Pennsylvania. Does anyone see any illegality to doing this? And in addition to renting space, is it legal to pay a fee to the salon owner for her marketing her clients and possible use of her equipment?(i.e.suppose the salon owner leases the laser.This can be done in PA if I am supervising.) In this case I would either perform the service myself or my NP would perform with me on site.
Any ideas would be helpful.

Its not a privacy violation and you can in discretionary procedures give a referral fee. Thats why now there's Botox Theraputic (OK for "medical indications) and Botox Cosmetic where Allergan can give discounts based on your use volume ( No volume disc on Theraputic botox as it has a MediCare code--kickbacks--same as volume discounts--- are a No-No w/ Medicare theraputic use.)

You really need to watch the "kickbacks". Look at some of the societies you belong to and even though it may be legal the Societies frown upon it. I belong to the AACS and ASLMS and both tell you not to do this in your contract with them.

I would also watch it if you take medicare or medicaid in your office. Just the perception of kickbacks could cost you dearly.

Hi,
I was recently scammed by a laser clinic in California as the are going out of business and taking my money with them. I am trying to find the laws regulating these clinics as far as the physician's involvement - does the physician have to be on site for a nurse to provide laser hair removal treatments?

Hey PO

Thats why i tell all my consults to do their homework and make sure they are going to a laser clinic with properly trained nurses or physicians. Also make sure you know what kind of laser they are using and if its going to get you the results you want. There are always shady people out there but you have a responsibility to do your homework also!

Check with your Attorney General's office and file a complaint with them to get your money back.
Contact the Medical Board to see who is listed as the medical director-contact that person for your money or file a complaint against his/her license.
Who was the laser clinic?

Hey PO,

If you paid by a credit card or Care Credit account, you might also want to check the back of a statement to see what billing rights you have or possibly call them to see what steps you need to take. If the med spa is not trying to correct the situation with you, you could possibly get a refund for your services placed back on your account.

I had an issue with a med spa here in California and used Care Credit to pay for the services. I wrote to Care Credit about being unsatisfied with the quality of goods and services I purchased.It took about six weeks, but I got a full refund back. You still have rights as a consumer, and if you paid for services that were not rendered then you are owed a refund.

Hello Everyone,

I was wondering if anyone could help answer this:

Is it legal to use an IPL hair removal ligth machine in the state of NJ -NOT- under the supervision on a doctor? We have been getting some mixed answers and are unsure if we are able to lease this machine and create a client base out of the home?? We do not know the rules/regulations/laws in NJ and dont know how else to find out and found this site--Anyone know?

Thanks for the help!

The laws in Florida are pretty clear. The utilization of lasers is considered the practice of medicine. Generally speaking, under the direct supervision of a physician (i.e. - the physician is located somewhere in the office at the time of the procedure), almost anyone can operate a laser provided the physician feels he or she has sufficiently prepare

... provided the physician feels he or she has sufficiently prepared the individual performing the procedure. Direct supervision in this way is required for any non-physician provider under the board of electrology laws. However, a physician assistant (PA) or nurse practitioner (NP) practices medicine, so this law requiring direct supervision does not apply to them. I'm a PA, and I practice medicine under the supervision of a physician. The supervision can be direct or indirect. Indirect supervision means that the physician is at least available by telecommunications (phone, email, text message, etc.) if I should have any questions. Therefore, the physician does not need to be present in the building for me to operate a laser. I am considered an extension of the physician at that point and can legally do anything they do as long as it is within their scope of practice and we have previously discussed and agreed upon those parameters.

AnyideaANYONE,

The best thing to do is talk to the state medical board. Most of these laws fall under them. In most states it is considered the practice of medicine and the IPL must be purchased by a physician and then supervised by them.

We have been asked this question many times and it varies by state. My recommendation is to have a lawyer do this for you. I am always concerned about individuals that want to start doing these procedures with as little investment as possible. Please spend the time and money to make sure you can LEGALLY do these procedures and then invest in the training to become proficient at the technique and the technology.

The next thing I am going to ask you is what are you going to do if you have a complication? You better make sure you have some form of backup plan. I also think you need to understand these are medical procedures and can cause permanent scarring. These procedures should not be done out of the home. You also need to make sure you have malpractice insurance. If you don't someone is going to end up owning your home when you screw up.

The state of NJ had nothing on the books for laser hair removal until 2004. That was the first time they even wrote anything on it.That's when they decided that they could tax it and make soom money. It about the money. Prior to 2004 they had a catch all law which stated that laser was considered surgery. Therefor any one useing laser ether had to have hospital privilages or permision from the board. This means that every one in NJ that doing laser of any type from stop smokeing lasers to CO2's laser is breaking the law. They are hipocrits.They chose who ever they want to kill while there friends of the big shots have who ever they want to do laser hair removal and nothing happens to them. while they sit a laugh at who's getting killed.

NJ is the worst state, they have laws that are not enforced, if they did all the laser centers would be shut down.laser is cosiderered surgery in nj next time anyone decides to get laser hair removal ask if they have hospital privilages for laser hair removal. What hospital books an OR for hair removal. Ask to get a letter that they can do it. To make matters worse they tax you, which is not really done in any other state. Can someone explain this to me? I guess the billion dollar a yr.from the casinos is not enough for this state. Next time you want to go to the beach try a place that is clean and not get stuck by a hpodermic needle while swimming.GH.

NL:

A belated response to your question about Tennessee law. There is a proposal before the board to change the regulations concerning the use of lasers. This is being initiated by a derm in Nashville who has a rather large day spa. It basically states that a physician be required to be on site for at least 8 hours per week and that if a medical director is used, that they have to be actively using lasers in their practice.

We can argue all day long about the use of lasers as being the practice of medicine. I for one, feel that there is a dividing line between ablative and non ablative lasers. Based what I see on this blog and regs other states, the operation of TANNING BEDS would be the practice of medicine.

Education and training should be the prime component of any legislation. Just having a doctor on site is not a panacea. Sure people can get burned. You can get burned by holding on light bulb too long. The insurance underwriters,who are the ultimate judge of risk, consider this industry low risk. We pay less than $7000 per year for professional liability insurance.

If you have any further questions, please feel free to email me.

I have been lasered at least 8 times, and never once was the doctor ever there....I was wondering what the law in Ca. is? i have been to 2 places and never was the doc there....

Lasers and IPL devices used to perform hair removal or to perform other dermatological procedures are classified by the FDA as prescription medical devices. The FDA has published that lasers should be used only under the direction of a licensed practitioner. Each state is permitted to regulate the use of medical lasers and can define who can or cannot use such devices.

Regulations are different in each state. In New Jersey, laser hair removal can only be performed by a physician licensed by the New Jersey State Board of Medical Examiners. The use of a laser or IPL device to perform hair removal procedures or skin rejuvenation cannot be delegated to a nurse, technician or anyone else who does not hold a license issued by the Board of Medical Examiners.

In Pennsylvania, the published regulations allow a physician to delegate laser procedures to anyone deemed qualified.

In Pennsylvania, the law involving the delegation of medical services permits procedures to be performed by "technicians" if these services are rendered under the supervision of the physician, and if the delegation is consistent with standards of acceptable medical practice embraced by the physician community. The regulations do not expressly state that the physician needs to be on site; however, a physician should be immediately available.

Consumers, under Pennsylvania law, are required to be informed that the laser procedure has been delegated by a physician, and the facility must verify that the consumer does not object to the delegation. Moreover, for any delegated procedure, the physician remains responsible for any complication.

In Pennsylvania, a physician associated with a spa should confirm that the spa's insurance policy expressly includes bodily injury claims from laser hair removal, and that coverage applies if the procedure is performed or delegated by the physician to a non-physician. The physician should verify the qualifications of those who will be using the laser, and have a procedure in place to verify that a patient's skin is tested before treatment begins. Informed consent guidelines should also be implemented.

Need some help on this one. A Chiropractor in NJ is being brought up on allegations by the Board of Chiro. for illegal use of a laser hair removal device. He was sold and trained by a company who claimed to be selling a light/heat machine, not laser. However, the Company who sold the machine is wishy washy as to whether or not it is an actual laser machine. This person also knows of several individuals using the same machine and practice. Some are not even medically trained at all. A law suit has ensued and the question posed is this: Was the Chiro. at fault for suspected burns on a patient IF the patient signed consent and used a tanning salon at the same time and IF the company sold a non-laser product? Also, what is the Board's responsibility in this matter other than passing the buck???

It sounds to me like the chiropractor was probably using the Radiancy pulsed light device (they utilize pulsed light + heat from a hot electric wire in their pulses). The lawyers will have fun with this one.

Can anyone tell me who is allowed to perform IPL treatments, not hair removal, in the state of Florida?

Amanda: The relevant (2007) Florida statute -- which covers supervisory relationships, standing orders, protocols, etc. relating to the use of lasers OR other light based devices for hair removal and other applications -- is Section 458.348. You can locate a copy of this statute via GOOGLE. You may wish to retain a Florida attorney to assist in interpreting the statute.

Amanda

MD DO PA NP

Does anyone know what the law requires in the state of Wisconsin...for the operation of IPL, hair removal and the x-trac laser for psoriasis???? We operate as a separate entity but within a dermatology practice. We have an aesthetician operating the laser for hair removal and the IPL.We have another person without any formal training doing treatments on the x-trac laser.The supervising physician is often on premise but does not supervise all treatments.Is any kind of "license" required for these operators for liability purposes??? Any help appreciated...Chrissie

can anyone give me information on laser hair removal laws in california relating to who can perform this procedure. thanks

Frankie:
In CA, the laws allow for RN, PA, NP and MD's to do laser-related procedures such as IPL, LHR, Fraxel, etc. It is not legal for aestheticians nor cosmotologists to do such.

Oddly enough, NC allows 3 types of licensees to perform laser/IPL for hair removal: physicians, hospital employees who are working for a board-certified dermatologist, and licensed electrologists who get 30 hours of training and spend $150 for a license. But it takes 600 hours of training, an exam, and a fee to become a licensed electrologist. We know who had there lobbying act together a few years ago, now, don't we?

Does any one know what the tenn. statute is for useing a q switch laser for tattoo removal? who can do it and such.

I apologize for yet another New Jersey question! It is all still so sketchy - can an aesthetician in a MedSpa perform Laser Hair Removal legally, without the Physician present? Does "present" mean in the actual room, or can it mean that the Physician is in "office" that day, but not directly in the room supervising the procedure?

Better yet - when it comes to Laser, IPL, etc laws, I can't find the proper website location. I'd really appreciate the info if anyone has it. Calling Newark is next to useless...

Thank you!

Dear DiJolie - Having the same issue - called Newark several times, spoke to the board of nursing and all they do is refer you to the algorithm for Scope of Practice which tells you nothing about what you can actually, legally, or physically do. Any one who is performing these procedures will tell you that medical supervision and standing orders are required, however, the NJ State Board of Nursing does not define what that means. SO, we are left in a state of ambiguity. The only ruling I could find is that RNs are legally able to give Botox injections, but no mention of dermal fillers, which is also, oh my god, an injection (god forbid a nurse should inject somebody...duh). Lasers are still the territory of physicians as far as I know, but again, its the "supervision" question that remains to be answered. This is what I don't understand...the doctor never supervises me when I start an IV, hang a bag of fluids, or even code a cardiac arrest (I am a pre-hospital RN, so it's all standing orders) so why do I need a doctor to watch me laser or inject fillers?? I don't know the answer, but I'm thinking about paying a lawyer to find out for me because its silly for me to put my license on the line even though I am well trained in esthetics, amongst other things...

In New Jersey, laser or IPL hair removal can only be performed by a physician, and the term physician is defined as a person holding a plenary license issued by the New Jersey State Board of Medical Examiners. New Jersey has consistently recognized that the use of a laser or light based device on a patient’s skin can only be used by a licensed physician. The use of a laser or light based device in a physician’s office is regulated by the State Board of Medical Examiners.

The State Board of Medical Examiners reviewed prior inquiries to determine whether non-physicians can use laser or IPL devices for hair removal. According to published Minutes, the Board has determined that only licensed physicians can use such devices for hair removal. On June 20, 2003, the Physician Assistant Advisory Committee of the New Jersey Board of Medical Examiners expressly stated that laser hair removal can only be performed by a physician.

The June 20, 2003 minutes stated:

b. The Committee reviewed a fax from Wanda Cooper, Sona International Corporation inquiring (1) as to whether a physician assistant is considered a nurse and therefore subject to the ruling of the Board of Medical Examiners regarding Thermolase laser; (2) as to whether the Board of Medical Examiners governs the Physician Assistant Committee and (3) whether a physician assistant can perform laser hair removal under the direct supervision of a physician.

As to the first question, it was the consensus of the Committee that physician assistants are not nurses.

As to the second question, the Board of Medical Examiners governs the Physician Assistant Advisory Committee.

As to the third question,consistent with the determination made by the Board of Medical Examiners, physician assistants may not perform Thermolase laser hair removal as these procedures are deemed the practice of medicine and may not be delegated to a nurse or any other licensed health care professional other than a "physician".

A letter will be sent to Ms. Cooper so advising along with a copy of the statutes and regulations which govern the practice of physician assistants in the State of New Jersey.

On September 19, 2003, the Physician Assistant Advisory Committee of the New Jersey Board of Medical Examiners expressly stated that laser hair removal can only be performed by a physician, and that IPL photofacial or IPL procedures would be referred to the Medical Board to determine their position.

The Board stated:

c. The Committee reviewed a fax from Bryan A. Manhardt, PA-C, Allergy Asthma & Sinus Center, Somerville, NJ 08876, inquiring as to whether procedures for Microderm abrasion, Laser hair removal, IPL photofacial, Botox injections and Collagen injections can be performed under the supervision of a physician. The Committee determined, as to Laser hair removal and Botox Injections, consistent with the determination made by the Board of Medical Examiners, physician assistants may not perform these treatments as these are deemed the practice of medicine and may not be delegated to a nurse or any other licensed health care professional other than a "physician".

As to procedures Microderm abrasion, IPL photofacial and Collagen injections there is no policy statement from the Board of Medical Examiners at this time. A letter will be sent to Mr. Manhardt so advising, along with a copy of the draft proposal as it relates to these procedures which is not yet law.

d. The Committee reviewed a letter from Dr. Edwin P. Schulhafer, Allergy, Asthma & Sinus Center, inquiring as to whether nurses, physician assistants or nurse practitioners in the State of New Jersey can perform the following procedures: Laser hair removal; Laser skin rejuvenation; Endomology; Intense Pulse Light (not a laser but a visible light); Botox injections; Collagen injections and Microdermabrasion.

It was the consensus of the Committee that, as to Laser hair removal and Botox Injections consistent with the determination made by the Board of Medical Examiners, physician assistants may not perform these treatments as these are deemed the practice of medicine and may not be delegated to a nurse health care professional other that a "physician". The Committee has no jurisdiction over nurses and nurse practitioners. This inquiry will be referred to the Board of Nursing.

As to laser skin rejuvenation, Endomology, Intense pulse light (not a lser but a visible light), Collagen injections and Microdermabrasion, there is no policy statement from the Board of Medical Examiners at this time. A letter will be sent to Dr. Schulhafer so advising along with a copy of the draft proposal as it relates to these procedures which is not yet law.

On April 16, 2004, the Physician Assistant Advisory Committee of the New Jersey Board of Medical Examiners expressly stated that IPL devices used for hair removal can only be performed by a physician.

The published minutes from April 16, 2004 stated:

b. The Committee reviewed a letter from Jason Staback, PA-C, inquiring as to whether it is legal for physician assistants in the State of New Jersey to use IPL (Intense pulse light) device for the purpose of hair removal, made by Palomar. He stated that it is categorized as a category 2 device. It was the consensus of the Committee that a letter be sent to Mr. Staback advising based on the limited facts presented, consistent with the determination made by the Board of Medical Examiners, physician assistants may not perform laser treatments as these procedures are deemed the practice of medicine and may not be delegated to a nurse, or any other licensed healthcare professional other than a "physician". To the current time, the performance of microdermabrasion and glycolic acid peels have also been considered the practice of medicine but unlicensed personnel have been permitted to perform theses procedures under the supervision and direction of a physician . However, please be advised that the Board is further investigating this latter issue and obtaining opinions from appropriate expert professionals. If the Board promulgates a regulation in this regard in the future it will be noticed in the New Jersey Register. Mr. Staback will be so advised.

On September 17, 2004, the committee stated:

The Committee reviewed a letter from Thomas Geary, PA-C, inquiring as to whether a physician assistant in the State of New Jersey can perform hair removal, tatoo removal and resurfacing if the supervising physician is a D.O. The Committee determined that based on the limited facts presented, consistent with the determination made by the Board of Medical Examiners, physician assistants may not perform laser treatments as these procedures are deemed the practice of medicine and may not be delegated to a nurse, or any other licensed healthcare professional other than a "physician".

In New Jersey, a physician cannot delegate laser hair removal procedures, laser skin resurfacing, or laser skin rejuvenation, to a physician’s assistant, a nurse, or any other licensed healthcare professional other than a "physician", which is defined as a licensed medical doctor. This position was stated on October 21, 2005, May 18, 2007, and reaffirmed again in September 2007. See Minutes, Physician Assistant Advisory Committee, September 21, 2007.

As recently as January 15, 2008, the New Jersey Board of Nursing did not approve of a licensed practicing nurse to administer IPL therapy. The Nursing Board Minutes stated:

Re: Inquiry from Doug Doyle, Esq., questioning whether Licensed Practical Nurses may administer “intense light pulse” therapy.

The Committee reviewed the e-mail and an article regarding Intense Pulse Light Therapy (IPL). The article stated that “IPL systems work on the same principles as lasers in that light energy is absorbed into particular target cells with color (chromophores) in the skin. The light energy is converted to heat energy, which causes damage to the specific target area.”

The Board of Nursing does not have regulations regarding administration of intense pulse light. On November 16, 2004, the Board of Nursing discussed this issue and made a motion to refer the issue to the New Jersey Board of Medical Examiners concerning the use of medical light–emitting devices (Lasers).

Consistent with the Board’s decisions of November 16, 2004, the Committee recommends that Mr. Doug Doyle’s question be forwarded to the New Jersey Board of Medical Examiners for review and comments.

As of 2008, the New Jersey Board of Medical Examiners consistently has taken the position that the use of laser or IPL device is the practice of medicine.

You can search the website of the New Jersey Board of Medical Examiners to review meeting minutes to update the above research. http://www.state.nj.us/lps/ca/bme/minutes/bmemin.htm. And, you and your employer should consider consulting an attorney or the medical board in your state for further clarification.

(This comment has been posted to the main blog here: http://www.medicalspamd.com/the-blog/2009/1/18/laser-hair-removal-in-new-jersey.html)

In the state of Indiana anyone that has been properly trained on the use of the machine can legally use it. The courts have ruled that the proceedure is no different that a tanning salon or tattooing. The cause number is 71C01-0705-PL-112, OBGYN Associates of Northern Indiana vs Tammy Ransbottom. Hope this helps.