Complementary and alternative Health Care Client Bill of Rights

Please read, print and sign this complementary and alternative health care client bill of rights. I am providing you with this client bill of rights in accordance with Minnesota statue 146A governing unlicensed complementary and alternative health care practitioners. 1) Practitioner Name: Beth Krause Complementary and Alternative Health Care Title: Wellness Consultant Business Address: 9499 Wilton Bridge Road Waseca, MN 56093 Telephone Number: 507-461-2396 2) Degrees, training, experience, or other qualifications regarding the complementary and alternative health care being provided and the statutory important disclosure statement in bold print below: Dr. Janet Travell trained for Myofascial Pain and Trigger Point Therapy; Dr. Terry Oleson trained in Auricular Therapy, 25 years experience. Classroom presenter/instructor for the American Academy of Pain Management for CME. The State of Minnesota has not adopted any educational 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 commend a discontinuance of medically prescribed treatments. If a client desires a diagnosis from a licensed physician, chiropractor, or acupuncture practitioner or service from a physician, chiropractor, nurse, osteopath, physical therapist, dietician, nutritionist, athletic trainer, or any type of health care provider, the client may seek such services at any time. 3) NOTICE: A complementary and alternative health care client has the right to file a complaint with Advanced Biomedical Technologies. The following is the procedure for filing complaints: All complaints related to services rendered by employees of Advanced Biomedical Technologies must be submitted to Edward Leoffler. Each complaint must contain the following information. A) Clients name, address and telephone number, B) Employee/ practitioners name, C) Date of service, D) the Complaint and E) suggested solution. 4) Notice: Any client may file a complaint with the following office: Minnesota Department of Health 85 7th Place East., Suite 220 P.O. Box 64882 St. Paul, MN 55164-0882

Subd. 2. Prior to the provision of any service, a complementary and alternative health care client must sign a written statement attesting that the client has received the complementary and alternative health care client bill of rights. I hereby acknowledge receipt of the Client Bill of Rights and the attached documents incorporated therein, and I have had a full opportunity to ask any questions I have about this document and my rights as a client. I understand my rights as a client. ______________________________________ Client Signature ______________________________________ Parent/Guardian __________________ Date __________________ Date

Signors Legal Relationship to Client