Client Bill of Rights
Ayurveda, yoga, Tibetan Cranial, Reiki, and Thai massage are holistic complements to western medicine. They are not substitutes for a medical diagnosis or the services of a physician or other licensed health care provider. Susan Bernhardt is not licensed, registered, or certified by any state as a health care professional, other than as a licensed massage therapist. You should discuss any recommendations by Essence Ayurveda with your primary care physician or other licensed health care provider. Essence Ayurveda does not provide conventional medical disease diagnosis or prescription drugs, devices, or substances. Essence Ayurveda will not advise that anyone discontinue a course of care, including a prescription drug, that was recommended or prescribed by a licensed health care professional. The Food & Drug Administration has not evaluated any statements regarding herbal supplements that may be recommended, and herbal supplements are not intended to diagnose, treat, cure, or prevent any disease. Essence Ayurveda does not and cannot guarantee or predict the success of any services or products.
Susan Bernhardt's use of the terms "yoga therapy," "yoga therapist," "therapeutic yoga," and "therapeutic hatha yoga" are based on her completion of the Yoga Therapy program of the Rocky Mountain Institute of Yoga and Ayurveda and her certification as a Yoga Therapist by the International Association of Yoga Therapists. The use of these terms is not based on her RYT designation from Yoga Alliance.
Minnesota requires unlicensed complementary and alternative health care practitioners to provide clients a "Client Bill of Rights." Clients must sign to acknowledge receipt before services can be provided. The text of the Client Bill of Rights that Susan Bernhardt asks clients to sign appears below; you also can review and download the Client Bill of Rights here.
STATE OF MINNESOTA CLIENT BILL OF RIGHTS
COMPLEMENTARY AND ALTERNATIVE HEALTH CARE STATUTE, 146A.11
Please read and sign this
Complementary and Alternative Health Care Client Bill of Rights.
If you have difficulty reading or understanding this bill of rights, please tell me. Reasonable accommodations will be made for you.
Minnesota Statutes 146A.11 requires that the client be provided with the information in this form before receiving treatment that is considered to be complementary or alternative health care practices. The statute also requires that the client sign a written statement attesting that the client has received this complementary and alternative health care client bill of rights before the provision of any service.
1. Practitioner, Titles, Contact Information
Advanced Ayurvedic Practitioner
C-IAYT Yoga Therapist
Tibetan Cranial Teacher and Practitioner
Reiki Master Teacher
Essence Ayurveda & Yoga Therapy
881 Lincoln Ave.
Saint Paul, MN 55105-3147
2. Training, Experience, and Qualifications
In accordance with Minnesota state law, please take notice that
THE STATE OF MINNESOTA HAS NOT ADOPTED ANY EDUCATIONAL AND TRAINING STANDARDS FOR UNLICENSED COMPLEMENTARY AND ALTERNATIVE HEALTH CARE PRACTITIONERS. THIS STATEMENT OF CREDENTIALS IS FOR INFORMATION PURPOSES ONLY.
Under Minnesota law, an unlicensed complementary and alternative health care practitioner may not provide a medical diagnosis or recommend discontinuation of medically prescribed treatments. If a client desires a diagnosis from a licensed physician, chiropractor or acupuncture practitioner, or services of a physician, chiropractor, nurse, osteopath, physical therapist, dietitian, nutritionist, acupuncture practitioner, athletic trainer or any other type of health care provider, the client may seek such services at any time.
If at any time you have any questions or concerns about the services provided, please do not hesitate to let the practitioner know. Also, you may make a complaint to the following office:
Minnesota Department of Health
Health Occupations Program
Office of Unlicensed Complementary and Alternative Health Care Practitioners
PO Box 64882
Saint Paul, MN 55164-0882
4. Fees, Payments, Insurance. Initial Ayurveda / Yoga Therapy consultations last 1 1/2 to 2 hours, with a fee of $180. Follow-up appointments last approximately 1 hour and are $90. Tibetan Cranial, Reiki, private yoga sessions, and marma therapy are $90 for approximately 1 hour. For Thai massage, a 90-minute session, for $135, is recommended; a 60-minute session is $90. A two-hour Thai massage is $180. In addition to the above fees and as required by law, sales tax is collected on Tibetan Cranial, Reiki, Thai massage, and marma therapy. Unless other arrangements have been made in advance, payment for Services is due at the time Services are provided and can be made by cash, credit card, or check.
Please provide at least 24-hours’ notice of cancellation or rescheduling. If you need to cancel or reschedule within 24 hours, please contact us as soon as possible. Payment of the fee for Services may be required if you cancel or reschedule within 24 hours of the appointment time. There is no fee if the reason is a cold or other illness that may be contagious.
We do not submit or handle insurance claims, and we do not communicate with insurance companies. Receipts will be provided on request. We do not have any reimbursement or other agreements with any insurance companies or any health maintenance organizations. We do not accept Medicare or medical assistance.
A sliding fee schedule based on need is available for Services. Please let us know when you schedule your appointment if you would like to talk about a sliding scale fee.
Payment for Products is due when the Products are ordered, except for customized herbs and oils where the price cannot be determined until they are prepared. You will need to pick up all Products that you order. If payment was not made at the time the order was placed, you can pay online or by leaving a check or cash when you pick up the Products. For customized Products, a price estimate can be provided upon request before you place your order, and placing an order is your agreement that will pay for them when they are ready. In addition to the price of Products, sales tax is collected on Products as required by law. Please note that there is a markup on Products that we supply and that we may receive a commission on Products that we suggest you purchase, such as through an affiliate account with a vendor we recommend.
5. Change in service or charges. The client has a right to reasonable notice of changes in services or charges.
6. Approach used by the practitioner in providing services to the client.
Ayurveda is the traditional healing science of India and offers a holistic approach focused on helping people live healthy and well-balanced lives. Yoga likewise is an ancient tradition of India and encompasses practices designed to promote the health of the body, mind, and spirit. Both involve individualized programs based on the client's unique constitution and on any imbalances that the client may be experiencing. Recommendations can be drawn from all facets of Ayurveda and classical yoga, such as diet and nutrition, daily routine and lifestyle, herbal supplements, yoga postures, cleansing practices, breathing practices (pranayama), deep relaxation, meditation, yoga nidra, and marma (acupressure) therapy.
Tibetan Cranial therapy is a disciplined technique designed to realign and restore our innate capacity for self-healing. During the session, the clothed recipient lies on a special wood table while the practitioner works on the head, face, and neck, using pulses to help the recipient achieve optimal balance. Tibetan Cranial therapy can bring relief in many conditions, in addition to giving an overall sense of feeling better.
Thai Yoga Massage uses both pressure and stretching of the clothed recipient to alleviate tightness in the muscles and other body tissues as well as address constriction in the flow of energy. Thai Massages are customized to be therapeutic as well as relaxing.
Reiki is a gentle energetic healing practice that supports relaxation and helps bring balance to the body, mind, emotions, and spirit. During a session, you will remain clothed and lie on a massage table or otherwise find a comfortable position. The practitioner’s hands will either rest gently, without pressure, on your body or be near your body.
The healing modalities that we offer recognize each person as unique and perfect, and view the whole of each person - body, mind, and spirit. Each modality employs natural methods that work with and take advantage of the body's innate healing abilities. As a result, these practices aim to truly restore health.
For more information about these healing arts and the practitioner’s approach, please visit www.essenceayurveda.com.
7. Assessment and Recommendations. The client has a right to complete and current information concerning the practitioner’s assessment and recommended service that is to be provided, including the expected duration of the service to be provided.
8. Courteous Service. Clients may expect courteous treatment and to be free from verbal, physical, or sexual abuse by the practitioner.
9. Confidentiality. Client records and transactions with the practitioner are confidential, unless release of these records is authorized in writing by the client, or otherwise provided by law. Please note that a parent who obtains complementary and alternative health care for the parent's minor child is not relieved of the duty to seek necessary medical care consistent with the requirements of Minnesota Statutes sections 609.378 and 626.556. A complementary or alternative health care practitioner who is providing services to a child who is not receiving necessary medical care must make a report under Minnesota Statutes section 626.556. A complementary or alternative health care provider is a mandated reporter under Minnesota Statutes section 626.556, subdivision 3.
10. Records. The client has the right to be allowed access to records and written information from records in accordance with sections 144.291 to 144.298 of the Minnesota Statutes, available at https://www.revisor.mn.gov/statutes/cite/144.291.
11. Other Community Services. Other similar services may be available in the community. Possible sources of information are Internet searches, a directory of Ayurvedic practitioners maintained by the National Ayurvedic Medical Association (https://ayurvedanama.site-ym.com/search/custom.asp?id=945), a directory of C-IAYT Yoga Therapists maintained by the International Association of Yoga Therapists (https://yogatherapy.health/find-a-therapist/), a directory of Tibetan Cranial practitioners maintained by the Tibetan Cranial Association (http://tibetancranial.org/wp/practitioners-apprentices-new/), and a directory of massage therapists maintained by the American Association of Massage Therapists (https://www.amtamassage.org/findamassage).
12. Choosing Practitioners. The client has the right to choose freely among available practitioners and to change practitioners after services have begun, within the limits of health insurance, medical assistance, or other health programs.
13. Coordinated transfer. The client has a right to coordinated transfer when there will be a change in the provider of services.
14. Right to Refuse Service. The client may refuse services or treatment, unless otherwise provided by law.
15. No Retaliation. The client may assert the client’s rights without retaliation.
I attest that I have received a copy of the Complementary and Alternative Health Care Client Bill of Rights before the provision of any service.
Signature of participant or parent/legal guardian Date
Name of participant or parent/legal guardian – please print