Disclaimer &
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

Susan Bernhardt
Advanced Ayurvedic Practitioner
C-IAYT Yoga Therapist
Tibetan Cranial Teacher and Practitioner
Reiki Master Teacher
Massage Therapist
Yoga Teacher

Essence Ayurveda & Yoga Therapy
881 Lincoln Ave.
Saint Paul, MN 55105-3147
612.208.6289
susan@essenceayurveda.com

Minnesota Clinic for Health & Wellness
900 Long Lake Rd., Ste. 160
New Brighton, MN 55112
612.706.9630
sbernhardt@mnclinicforhealth.com

2. Training, Experience, and Qualifications

Education

SWARTHMORE COLLEGE, B.A. with High Honors (Economics and Mathematics), 1983.

STANFORD LAW SCHOOL, J.D. with Distinction, 1986.

ROCKY MOUNTAIN INSTITUTE OF YOGA & AYURVEDA. Completed 1500-hour Ayurvedic Medicine and Yoga Therapy Professional Certification Training Program, November 2012.

AYURVED SADHANA VIDYALAYA. Completed Advanced Ayurvedic Practitioner Program (Ayurved Parangat), October 2019.

AXIS YOGA TRAININGS. Completed 200-hour yoga teacher training program, January 2010; completed 300-hour advanced teacher training program, February 2016.

TIBETAN CRANIAL ASSOCIATION. Certified Teacher since May 2019; Practitioner since May 2014; Apprentice, 2012 – 2014.

DENVER INTEGRATIVE MASSAGE SCHOOL. Graduated from 600-hour massage therapist program focusing on Thai Yoga Massage, November 2013.

REIKI MASTER TEACHER. Certified as a Reiki Master Teacher in the Raku Kei Reiki lineage by Richard Gubbe, November 2013 and in the Usui / Tibetan System by Donna Lambdin, June 2016.

ADDITIONAL TRAINING. Dr. Vasant Lad (Ayurveda Institute), Pulse Intensive and Marma Intensive, 2014. Various other classes and workshops in Ayurveda, Yoga, and Thai Massage.

Experience

ESSENCE AYURVEDA, LLC. Founded Essence Ayurveda for providing the complementary health care services described below, 2012 – present.

AYURVED SADHANA VIDYALAYA. Teach various classes in Ayurveda Practitioner programs, 2017 – present.

METROPOLITAN STATE UNIVERSITY OF DENVER. Affiliate Faculty for Ayurveda course, 2016 – 2019.

AXIS YOGA TRAININGS. Taught in the 200-hour and 300-hour yoga-teacher training programs, 2015 – 2019.

KINDNESS YOGA. Taught pranayama and meditation in teacher training program, 2011. Taught Hatha Yoga class, 2013 – 2014.

VARIOUS SCHOOLS AND YOGA CENTERS: Guest lecturer and workshop teacher.

Additional Certifications

NATIONAL AYURVEDIC MEDICAL ASSOCIATION. Board-Certified Ayurvedic Practitioner. Recognized as an Ayurvedic Yoga Therapist.

INTERNATIONAL ASSOCIATION OF YOGA THERAPISTS. C‑IAYT Certified Yoga Therapist.

YOGA ALLIANCE. RYT 500.

COLORADO LICENSED MASSAGE THERAPIST, MT.0016135.

ST. PAUL, MN LICENSED MASSAGE THERAPIST, License # 20200000150.

NEW BRIGHTON, MN LICENSED MASSAGE THERAPIST, License # 2022-026

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.

3. Complaints.

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
Health.HOP@state.mn.us
Phone: 651-201-3731
Fax: 651-201-3839
Health.HOP@state.mn.us
https://www.health.state.mn.us/facilities/providers/compalt/index.html

4. Fees, Payments, Insurance. Initial Ayurveda / Yoga Therapy consultations last 1 1/2 to 2 hours, with a charge of $180. Follow-up appointments last approximately 1 hour and are $90. Herbs and oils, if recommended, are an additional charge. 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 charges, sales tax is collected on Services and Products as required by law. Please provide at least 24-hours’ notice of cancellation. If you are ill and may be contagious, please reschedule.

Please note: tips are not expected.

Unless other arrangements have been made before the appointment, fees for services are payable at the time of service by cash, check, or credit card. Herbs and oils generally are customized for you, and you must pick them up after the appointment. Amounts are based on the particular herbs and oils as well as quantities. A cost estimate can be provided in advance upon request. You can pay for herbs, oils, and other supplies online, or you can leave a check or cash when you pick them up.

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. Please let me know when you schedule your appointment if you would like to talk about a sliding scale fee.

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 & Yoga Therapy

Ayurveda is the traditional healing science of India. Ayurvedic medicine offers a holistic approach focused on helping people live long, 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. Susan develops individual programs for each client based on that 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

Tibetan Cranial 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 can bring relief in many conditions, in addition to giving an overall sense of feeling better.

Thai Yoga Massage

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

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.

Overall Approach

The healing modalities that Susan offers all recognize each person as unique and perfect, and view the whole of each person - body, mind, and spirit. Each modality also employs natural methods that work with and take advantage of the body's innate healing abilities. As a result, these practices all aim to truly restore health and not merely relieve symptoms.

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.

CLIENT ACKNOWLEDGMENT

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