COMPLEMENTARY AND
ALTERNATIVE
HEALTH CARE CLIENT
BILL OF RIGHTS
This is a notice of your rights provided pursuant to Minnesota
Statutes 146A.11.
March, 2014
In Minnesota, all unlicensed complementary and alternative health care practitioners are required to provide a
written “client bill of rights” to all clients prior to providing treatment. A copy of the client bill of rights must also be
posted in a prominent location in the office of the practitioner.
This notice is given to all clients of Rolfing® St. Paul by Breana Larson, Certified Rolfer™, not just to meet the
statutory requirements, but to assure all Rolfing® St. Paul clients that Breana’s practice reflects only the highest
professional standards, and a skilled, knowledgeable approach with the ultimate concern for client comfort and
satisfaction.
In providing this notice, reasonable accommodations will be made for those clients who cannot read or who
have communication disabilities and those who do not read or speak English.
Please be aware 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.
Also, under Minnesota law, an unlicensed complementary and alternative health care practitioner may not
provide a medical diagnosis or recommend discontinuance of medically prescribed treatments. If a client desires
a diagnosis from a licensed physician, chiropractor, or acupuncture practitioner, or services from 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
Any client of Rolfing® St. Paul that has a complaint about Breana’s practice may file their
complaints at her office in person, by phone, by mail or by email. All contact information is listed at the top of this
notice. Rolfing® St. Paul must report any complaints received, or complaints can be directed to the state agency
listed below, known as “OCAP”. A complaint form is available on their website at
http://www.health.state.mn.us/divs/hpsc/hop/ocap/ocapcomp.html, or a paper copy is available from Rolfing ® St.
Paul upon request. Clients that exercise their right to file a complaint are assured they may do so without fear of
retaliation.
Office of Unlicensed Complementary and Alternative Health Care Practice
Health Occupations Program
Minnesota Department of Health
P.O. Box 64882
St. Paul, Minnesota 55164-0882
Per unit fees for services Standard rates for services are: 60-75 minute session $108, “Ten Series” ten (10)
session package $972 (tenth session is free). Forms of payment currently accepted are cash, check, and
Paypal. Payment plans are available for the Ten Series and other advertised multiple session package specials,
subject to sale dates and other terms of advertised specials. Rolfing® St. Paul does not accept Medicare or any
type of medical assistance payments, nor does Rolfing ® St. Paul bill health insurance or medical reimbursement
plans directly. Itemized receipts will be provided to the client for those purposes. No waivers of payment will be
extended.
Theoretical approach As a Certified Rolfer™, Breana is a practitioner of Rolfing® Structural Integration (SI),
named after its founder, Dr. Ida P. Rolf. Rolfing® SI is a form of bodywork that reorganizes the connective
tissues, called fascia, that permeate the entire body.
More than fifty years ago, Dr. Rolf recognized that the body is inherently a system of seamless networks of
tissues rather than a collection of separate parts. These connective tissues surround, support and penetrate all
of the muscles, bones, nerves and organs. Rolfing® SI works on this web-like complex of connective tissues to
release, realign and balance the whole body, thus potentially resolving discomfort, reducing compensations and
alleviating pain. Rolfing® SI aims to restore flexibility, revitalize your energy and leave you feeling more
comfortable in your body.
Essentially, the Rolfing® process enables the body to regain the natural integrity of its form, thus enhancing
postural efficiency and your freedom of movement.
Notice of changes in services or charges
Clients of Rolfing® St. Paul have the right to receive reasonable
notice of changes in services or charges. Every effort will be made by Rolfing® St. Paul to provide updates in the
bill of rights notice to clients whenever significant changes in the practice are made.
Rights regarding your records:

the right to complete and current information concerning the our assessment and recommended service
that is to be provided, including the expected duration of the service to be provided;

your records and transactions with the Rolfing® St. Paul are confidential, unless release of these records
is authorized in writing by the client, or otherwise provided by law;

you have the right to access records and written information from records in accordance with sections
144.291 to 144.298 of Minnesota Statutes.
Other rights of Rolfing® St. Paul clients:

the right to expect courteous treatment and to be free from verbal, physical, or sexual abuse by the
practitioner and any other employees or associates of Rolfing® St. Paul;

be aware that other services may be available in the community, including where information concerning
services is available;

you have 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;

you have the right to coordinated transfer when there will be a change in the provider of services;

you may refuse services or treatment, unless otherwise provided by law.
For more information contact Breana Larson, Certified Rolfer™, at Rolfing® St. Paul.
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Attention Rolfing® St. Paul clients: Please read the foregoing notice of your rights and sign below. The signed
original copy will be kept on file at the offices of Rolfing® St. Paul. An electronic or paper copy of this signed
notice will be provided upon request. A copy of this notice can also be found posted at the office of and on the
website of Rolfing® St. Paul.
Client name _________________________________
Date _______________________________
I have received and have access to the “Complementary and Alternative Health Care Client Bill of Rights” from
Rolfing® St. Paul pursuant to the laws of the state of Minnesota.
Client signature ________________________________________