(a) A thorough evaluation of the patient's psychiatric and physical status with review of pertinent laboratory findings shall be done within 30 days prior to the initiation of a course of ECT and shall be recorded in the patient's permanent medical record. Physical evaluation shall include a neurological examination. Other determinations shall include, but not be limited to, the following:(1) laboratory as appropriate to medical history and/or conditions, such as:(A) complete blood count;(B) electrolytes; and(C) serum pseudocholinesterase if there is no documentation of successful use of muscle relaxant medication with general anesthesia, and if there is no record of previous testing;(2) x-rays as appropriate to medical history and/or conditions; (3) electrocardiogram.(b) Abnormalities reported or found in the neurological or cardiac evaluation shall be evaluated by a medical specialist in the appropriate field, such evaluation to be incorporated in writing into the patient's permanent record prior to initiation of ECT.