Client Bill of Rights for Holistic Health Options       Dana Spates, 320-266-5476, or 320-243-7128                         

 

Services are available at 531 Maple St. Paynesville, MN56362, and 207 ½ Washburne Av., Paynesville MN

 

Degrees, Training, Experience, and Qualifications

 

Registered Yoga Instructor with Yoga Alliance  ERYT500

Certified Yoga Instructor, through Yoga Fit Completed 2 levels

Certified Personal Trainer, through NETA

MS of Natural Health, through Clayton College of Natural Health

Certified Healing Touch Practitioner - Healing Touch International

Certified Healing Touch Instructor - Healing Touch International

Three Heart Balancing - 2 + levels, through Jaentra Green Gardner, Minneapolis, MN

Integrated Energy Therapy - 3 levels

Thai Yoga Bodywork – Certified Thai Yoga Bodywork Practitioner

Ayurvedic Yoga Specialist - Himalayan Institute

 

Experience

12 years of experience teaching weight training to clients

3 years of teaching yoga through Community Ed

Personal yoga practice 12 + years

2 years teaching yoga through the Center for Health and Wellness, Paynesville, MN56362

10 years teaching yoga through Holistic Health Options

20 years of working at Country Cupboard health food store, Paynesville, MNas manager and five years of teaching classes regarding Weight Loss, Stress Reduction, and Exercise

10 years of teaching Aerobic Exercise

15 years of experience of working with Energy practices of Healing touch and Three Heart Balancing

3 years experience with Thai Yoga Bodywork

1 year of working with Ayurvedic Yoga Specialist training

 

In accordance with Minnesota state law, I am providing you with the follow notice:

“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, AND 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 LICENSES 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.”

Complaints:

If you have a complaint with the services you have received from Dana Spates you may complain to the appropriate area of certification:

Yogafit International:  811 No. Catalina Av. Suite 1102, Rendondo Beach, CA, 90277

Yoga Alliance, 7801 Old Branch Ave. Suite 400, Clinton, Maryland 20735

NETA:  5955 Golden Valley Rd. Suite 240, Minneapolis, MN55422

Healing Touch International: 12477 W Cedar Dr. Suite 206, Lakewood, CO 80228

 

Right to Complain:  If you have any concerns, you may file a complaint with the following office.  Office of Complementary and Alternative Practice( OCAP)

Minnesota Department of Health

P.O Box 64975, Suite 400

Metro Square Building

St. Paul, MN55164

651-282-5623

 

5.  Fees per unit of service:   Fees are payable at the time of service.  If you are unable to pay the full fee at the time of service, a payment plan can be arranged.  This plan must be agreed to in writing prior to the provision of services.  In order to receive services you must be current with your payment plan arrangement.  We do not handle insurance claims; however a receipt can be provided to you.   Fees vary according to the services provided, however this information will be agreed upon before services are provided.  Fees range from $60-$80 depending on the length of the session.   Appointments must be cancelled 24 hours prior to the scheduled time to avoid charges.

 

6.  Change in service or charges:    You have the right to reasonable notice of changes in services or charges, and I will provide prior notice of any changes.

 

7.  My theoretical approach:  It is my hope to educate you in ways that will enable you to improve your health through diet, exercise, stress relief, and energy practices.   It is my belief that we are each in control of our ability to improve our health using these tools, and I am simply here to guide and enable the process, within my scope of practice.

 

8.  Assessment and Recommendations:  You have the right to complete and current information concerning my assessment and recommended service, including the expected duration of the services to be provided.  If you have any questions please ask.

 

9.  Courteous Service:  You may expect the courteous treatment and to be free from verbal, physical or sexual abuse by your practitioner.

 

10.  Confidentiality:  Your records and transactions with me are confidential.  This information will not be released unless you authorize release in writing or unless release is required by law.

 

11.  Records:  You are allowed access to records and written information from records in accordance with section 144.335 of Minnesota Statutes.

 

12.  OtherCommunity Services:   Other similar services are available in the community.  Possible sources of information are Minnesota Wellness Directory, or the telephone Yellow Pages.  I will provide you with other resources to the best of my knowledge.

 

13.  Selecting and Changing Practitioners:  You have the right to choose freely among available practitioners and to change practitioners after services have begun.

 

14.  Coordinated transfer.   If you change practitioners, you have the right to my assistance in coordinating this transfer.

 

15.  Right to refuse Service:  You are free to refuse services or treatment.

 

16.  No retaliation:  You may assert your rights described in the Client Bill of Rights at any time without retaliation.

 

Acknowledgment

 

I have received a copy of the Complementary and Alternative Client Bill of Rights.  I have read and understand the Client Bill of Rights, or it has otherwise been read to me.  I have had full opportunity to ask any questions I have about this document and my rights as a client.  I understand my rights as a client.    Healing Touch therapy has been explained to me andI give permission to receive a Healing Touch Treatment

 

 

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Client or Legal Guardian’s Name Printed                                            Date

 

 

 

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Client or Legal Guardian’s Signature                                                   Date