Client Bill of Rights

Complementary & Alternative Health Care Client Bill of Rights

Jessica Jascha Clinical Herbalist, DBA Jascha Botanicals® 421 McIndoe St Owatonna, MN 55060 | 507-993-2403

As of July 1, 2001, Minnesota’s Freedom of Access to Complementary Care Law (Statute Chapter 146A) requires that you receive and acknowledge that you have received by your signature on this document the following information prior to your treatment.  Jessica Jascha, hereafter, “the Practitioner” has received the following education, training & credentials: 

The State of Minnesota has not adopted any educational and training standards for unlicensed complementary and alternative health care practitioners. 

Statement of credentials is for information purposes only.

The following were attended in person or via live or recorded webinars:

February 2019-December 2021: Sage Mountain Herbal Center. Intensive with Rosemary Gladstar in the didactic, therapeutic, laboratory, and fieldwork of herbalism. Certificate of Completion

2021-2022: Eclectic School of Herbal Medicine Clinical Program. Classes completed include:

-An Integrative Approach to Herbal Medicine

-Applied Clinical Nutrition

-Herbal Medicine for Acute Care

-The Art and Science of Plant Medicine Making

-An Integrative Approach to Insulin Resistance and Obesity

-An Integrative Approach to the Digestive System

-An Integrative Approach to the Nervous System

-An Integrative Approach to Systemic Inflammation

-An Integrative Approach to Mental Health

-The Theory and Application of Western Energetics

-Traditional Western Assessment and Consultation Process

-The Clinical Community Herbalist Certification

-An Integrative Approach to Autoimmunity

-An Integrative Approach to Thyroid Disorders

-An Integrative Approach to the Cardiovascular System

-An Integrative Approach to the Urinary System

-An Integrative Approach to the Respiratory System

-An Integrative Approach to the Lymphatic System

-An Integrative Approach to the Immune System

-An Integrative Approach to the Structural System and Pain Management

-An Integrative Approach to the Female Reproductive System

-An Integrative Approach to the Male Reproductive System

-Functional Bloodwork Interpretation

-An Integrative Approach to Fatigue

-Creating Effective Herbal Formulas

-Applied Herbal Pharmacology

March 2022: Admitted to American Herbalist Guild as an associate member in good standing as an intermediate level clinician.

April 2022: Webinar Andrew Bentley: Herbal Support for Long Covid

May 2022: Webinar Mel Kasting: PMDD

July 2022: Webinar Amy Branum: Working with Trauma in the Clinical Practice

August 2022: Webinar Matthew Wood and Phyllis Light: Herbalism The Undying Flame (A history of herbalism in the United States).

September 2022: Online Course Paul Bergner North American Institute of Medical Herbalism: Obesity and Weight Loss; Ethics, Harms, and a Metabolic Approach

October 2022: Webinar Guido Mase`: Step Out of Brain Fog

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 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, osteopathic physician, 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 the Client has a complaint or concern about the care or services they have received, the Client may also contact the Office of Unlicensed Complementary and Alternative Health Care Practice located in    Minnesota Department of Health:

Mailing address: P.O. Box 64882, St. Paul, MN 551640882

 Phone: 6512013728 Fax: 6512013839 Website: www.health.state.mn.us

Fees:       

  • Herbs: not included
  • Initial consultation fee: $200.
  • Follow up fee: $55 (30 – 60 minutes)
  • Note that herbs are to be started right away (within 24 hours of receiving them) unless the practitioner suggests otherwise. Also, note that if you wait too long, a new initial consultation/intake may be required as symptoms may have changed, which means that the herbal protocol will likely change as well. The practitioner can not in good conscience make herbal suggestions without knowing a client’s current status and symptoms. The fee for a new initial consultation (within 3 months) is $150. The fee for a new initial consultation (after 3 months) is $200 which does not include a free follow-up.

Payments/Insurance: The Practitioner accepts payments via the Practice Better platform, which uses Square. Payments are also accepted via Paypal.

This Practitioner is not on contract with any HMOs, PPOs, or any other Insurance Company to provide discounted services. This Practitioner does not accept Medicare, Medical Assistance, or general assistance medical care. Payment in full for services is expected at the time of service unless otherwise arranged prior to the appointment.

Cancellation:  A 24-hour notice is required for a change or cancellation of an appointment.  A cancellation fee of 75% of the service may be charged for a missed appointment or lack of 24-hour notice. 

Electronic Communication:  The client agrees that all electronic communication between client and practitioner may become part of the client file. The client certifies that they are aware that electronic communication, because of problems inherent with electronic media, cannot be guaranteed confidential, and if this is a perceived problem, will use other communication methods. 

CLIENT’S RIGHTS

● Change of Price: While changes in consult, follow-ups,  and remedy fees can occur, reasonable notice of those changes will be provided by the Practitioner when scheduling the appointment. 

● Right to Current Information: Clients have the 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. 

● Right to Confidentiality: Client records are confidential and will not be released unless authorized by the client in writing or as otherwise provided for by law. Client’s information may be discussed/shared anonymously in a classroom setting for educational purposes. 

● Right to Self-Access: Clients have the right to access to their own records maintained by the Practitioner’s office, in accordance with state statute sections 144.291 to 144.298 ( https://www.revisor.mn.gov/statutes/cite/144.291

● Personal Interaction: Clients have the right to expect courteous treatment, free from verbal, physical, or sexual abuse. 

● Other Treatment Available: Other herbal therapy services are available to the Client in this same community. These can be located by asking the Practitioner or searching online. 

● Right of Agency: 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 

● Records Transfer: The Client has the right to coordinated transfer of your records when there will be a change in the provider of services.

● Right of Refusal: The Client may refuse services or treatment unless otherwise provided by law. 

● Right of Non-retribution:  The Client has the right to assert any and all of the above-mentioned rights without retaliation from the Practitioner. 

Theory of Treatment: As an herbalist, the practitioner’s goal is to facilitate the body’s innate ability to heal itself. The practitioner takes a holistic approach, seeing each client as a unique individual. The practitioner utilizes Western concepts of organ systems, tongue and facial diagnosis intuition, and pulse testing.

Informed Consent: This entire form is the basic agreement of services between the client and herbal practitioner.  All nutritional supplements, herbs, extracts, etc. are taken at the client’s own risk. As with any ingested substance, an allergic reaction is a possibility in some individuals. The client attests that the practitioner has answered all his/her questions about services and they have explained the potential risks and benefits of services. The client understands that, although there may be benefits of services, change and symptom relief are not guaranteed and no warranty as to effectiveness is made by the practitioner. 

The practitioner and client both understand that only a physician (MD) can diagnose, treat, and prescribe medicines for illness or disease. As an herbalist and not an MD, the practitioner neither diagnoses nor treats disease but recommends herbs, dietary, lifestyle, and other modalities to help the body-mind to achieve optimal physical and emotional wellbeing. Any mention of named diseases is referenced as a part of the overall assessment and condition of the client. 

As appropriate and necessary, the practitioner encourages and advises clients to seek professional medical advice regarding any illness or disease they are suffering from. Background health information can aid in the process of a holistic, herbal program and therefore can be shared at the time of the herbal consultation. Any concerns about your health and supplementation with herbs or diet should be done in consultation with your doctor.