Unlicensed healers’ consent forms disclose their status, not your risk

Book a session with an energy healer, an herbalist or a bodyworker in Minnesota, and before anything else happens you’ll be handed a sheet to sign. Somewhere on it, in bold capital letters, is a sentence the state requires every one of them to print: “THE STATE OF MINNESOTA HAS NOT ADOPTED ANY EDUCATIONAL AND TRAINING STANDARDS FOR UNLICENSED COMPLEMENTARY AND ALTERNATIVE HEALTH CARE PRACTITIONERS.”

Most people sign it the way they sign a dentist’s intake form. It looks like informed consent. Legally, it’s a different instrument. In the handful of states with laws like Minnesota’s, that page is what an unlicensed practitioner trades for permission to work without being treated as someone practicing medicine illegally. It tells you who the practitioner is: not licensed, trained however they say they were trained, working from a stated theory, charging a stated fee.

What it doesn’t tell you is what could go wrong. None of the seven state laws read for this article requires a practitioner to explain the risks of the specific practice they’re about to perform. That gap is the subject here: which states have these laws, what the forms must contain, who enforces them, and how licensed complementary professions handle the same question. The duties a physician owes you before a procedure are the business of this library’s guide to clinical consent, so this piece stays with the practitioners those duties never reach.

Why medical consent rules leave a gap

Informed consent in medicine travels with a license. A physician, a nurse or a chiropractor answers to a state board, and the duty to explain risks is enforced through that board and the courts.

An unlicensed practitioner has no board. Their legal problem is more basic: in most states, the work itself can look like the unlicensed practice of medicine. California’s medical practice act, for example, makes it a public offense for someone without a certificate to practice or advertise any system of treating the sick. The penalty can reach a $10,000 fine, jail time or both.

The laws covered here solve that problem with a bargain. The practitioner gets an exemption from the medical practice act. In return, the client gets paperwork: a written account of the practitioner’s status, signed before any service begins.

Supporters, including the advocacy group National Health Freedom Action, call these safe-harbor laws. Jann Bellamy, a Florida lawyer who writes critically about them for the Science-Based Medicine site, labels them quack protection acts. Both sides describe the same mechanism. They disagree about whether it protects the public or the practitioner.

Notice what sits at the center of the bargain. The thing exchanged for legal protection is disclosure of status, not a conversation about risk. Almost everything else in this article follows from that design choice.

Seven states verified, and where the number 11 comes from

You’ll often read that 11 states have these laws. That figure has one traceable origin. In written testimony to North Dakota lawmakers dated January 29, 2021, Diane M. Miller of National Health Freedom Action stated that eleven states had passed safe-harbor exemption laws in some form, and listed them.

Bellamy’s critical article of April 8, 2021, also says 11. It gives no list, though. It links to the advocacy group’s own resource page instead. So the count that appears on both sides of the argument is really a single count, made by the group campaigning for the laws. No neutral legislative-research tally turned up.

Reading the statutes themselves confirms seven states:

• Minnesota, 2000. Its chapter 146A lists 22 kinds of covered practice, from aromatherapy, Ayurveda and homeopathy to healing touch, folk practices and culturally traditional healing practices.
• Rhode island, 2002, by the statute’s own history line. Its client bill of rights closely tracks Minnesota’s.
• California, 2002, through Senate Bill 577.
• New Mexico, effective July 1, 2009, under the Unlicensed Health Care Practice Act.
• Colorado, effective June 5, 2013, a law its legislative staff summarized as the Colorado Natural Health Consumer Protection Act.
• Maine, 2019.
• Idaho, where the exemption sits inside the state’s medical practice act. When that provision was added could not be established.

The advocacy list also names Louisiana, Oklahoma, Nevada and, for homeopaths only, Arizona. Louisiana does have a 2005 law, but it’s narrower. It covers people paid to advise on lifestyle, food, supplements or homeopathic remedies who aren’t licensed as health providers or dietitians, and requires them to say so in writing. Whether that’s what the advocates were counting is unclear. The Oklahoma, Nevada and Arizona entries couldn’t be confirmed from statute text for this article.

The map is still moving, slowly. A Massachusetts bill, Senate 1481, filed January 17, 2025, would create a similar exemption. Its official history, checked in October 2026, shows the public health committee reporting it favorably on October 14, 2025, and sending it to the health care financing committee. On January 29, 2026, that committee folded it into a study order, S2931, which authorizes the committee to study it along with a long list of other bills.

What the forms must say

The laws differ in detail but share a core. Before the first session, the practitioner must tell you in writing that they aren’t licensed, describe what they do and the thinking behind it, list their training and qualifications, and get your signature acknowledging that you received all of it.

The variations are where the useful information lives.

• California requires six written items, including the theory of treatment and the practitioner’s education, training and experience, in a language you understand. You get a copy of your signed acknowledgment, and the practitioner keeps it for three years. Any advertising must also say the person isn’t licensed by the state as a healing arts practitioner.
• Minnesota requires a 17-item client bill of rights, posted in the office and handed to you. It covers fees and insurance, a plain-language summary of the practitioner’s theoretical approach, confidentiality, access to records, how to complain to the state, and your right to refuse treatment.
• Rhode island requires a 16-item version with the same structure and its own bold-print statement that the state has set no training standards for unlicensed practitioners.
• New Mexico goes furthest on substance. Its patient information document must describe the nature and expected results of the services, along with fees, record access and the health department’s complaint address. If you can’t write, a witnessed oral acknowledgment is allowed. Records are kept three years.
• Colorado requires practitioners to say whether they carry liability insurance and to tell clients to discuss the practitioner’s recommendations with their other health care providers.
• Maine requires a posted copy of the disclosures and a signed statement, obtained before the first service, that you received and understood them. The practitioner keeps it for two years.

Read the Minnesota and Rhode Island credential statements closely. Each requires the practitioner to list degrees and training and then, in the same breath, to undercut the list: the state hasn’t set any standard, and the statement is for information only. Training claims in this field get their own scrutiny in the companion piece on judging practitioner training.

What none of them requires: the risks

Here is the hinge of the whole system. Not one of the seven statutes read for this article requires the practitioner to tell you the risks of the practice itself.

New Mexico comes closest, with its requirement to describe expected results. Minnesota and Rhode Island give you an explicit right to refuse. Idaho is the only one that calls its paperwork a declaration of informed consent. Yet the statute describes the declaration’s contents as an overview of the provider’s education, stating that the provider is not an MD or DO and is not licensed under the state’s medical chapter. That’s status again.

Consider what this means in practice. Minnesota’s list of covered practices runs from meditation to detoxification therapies, Gerson therapy and what the statute calls noninvasive instrumentalities. The required form is the same for all of them. A meditation teacher and someone running a detox protocol hand you identical disclosures.

Why would legislators build it this way? One clue sits in the findings section of California’s 2002 bill, which stated that these nonmedical services “do not pose a known risk to the health and safety of California residents …” That is a legislative finding written to support a bill, not the result of any safety study. It does help explain why risk disclosure wasn’t built in. The law assumed there was little to disclose.

Not everyone accepts that premise. Writing in Seminars in Oncology in 2002, Grace Powers Monaco and Gilbert Smith argued that the duty to disclose doesn’t change with the provider’s background or the label on the therapy, and that it binds licensed and unlicensed practitioners alike. That’s an ethical argument, not a statute. None of the states verified here has written it into law.

The limits the statutes do impose

What these laws lack in risk disclosure they partly make up for in prohibitions. Read side by side, they draw the same few lines.

• No diagnosing. Minnesota bars a medical diagnosis outright. New Mexico bars a specific conventional medical diagnosis. California bars diagnosing and treating where doing so creates a risk of serious harm or death.
• No advice to stop prescribed treatment. California, Minnesota and New Mexico each forbid recommending that a client discontinue medicine prescribed by a licensed clinician. Minnesota prints that limit on the disclosure form itself.
• No procedures that cross into medicine. In California, Minnesota and New Mexico, breaking the skin, setting fractures, X-rays and prescription drugs are off limits. Minnesota and New Mexico also exclude manipulating the joints or spine.
• Limits on children. Colorado bars these practitioners from treating children under 2, and allows treatment of children 2 through 7 only with signed parental consent and extra disclosures.
• Duties of conduct. Minnesota prohibits sexual contact with clients, misleading advertising and calling oneself doctor or physician, and New Mexico bars sexual contact with current patients or with former patients within a year. Minnesota also makes it a violation to fail to recommend a licensed provider when a client reasonably likely needs one.

Those prohibitions are the statutes’ own version of a principle this library follows throughout: decisions about prescribed treatment stay with the clinician who prescribed it.

Who is watching

A disclosure law is only as strong as the office that enforces it, and Minnesota’s record shows how thin that can be.

The state runs an Office of Unlicensed Complementary and Alternative Health Care Practice inside its Department of Health. Its biennial report for July 2002 through June 2004 counted 22 complaints in fiscal 2003 and 18 in fiscal 2004, against an estimated 3,000 practitioners. Massage therapists and bodyworkers were the largest identifiable group, and 83 percent of the complaints against them alleged sexual misconduct. Civil penalties collected in those two years totaled zero.

The report for 2008 to 2010 is starker. The office suspended operations from September 1, 2009, through June 30, 2010, because of state budget cuts known as unallotment. Complaints fell from 28 in fiscal 2009 to 3 in fiscal 2010. When the office reopened in July 2010, 49 complaints were open, 46 of them for more than a year.

Those are the most recent figures located for this article, and they’re old. Read them as a picture of how such an office can function, not as current statistics. The office still appears on the health department’s website, on a page last updated in July 2024.

For a client, the practical lesson is that the signed sheet may be the strongest protection you hold. It names the state office where complaints go, and it records in writing what the practitioner claimed about their training.

A statute that contradicts itself

Minnesota’s law also contains a contradiction this article can report but not resolve.

Section 146A.11, the bill-of-rights section, says it does not apply to licensed or registered health professionals who use complementary practices within the scope of their license. Section 146A.065, added in 2014, says licensed and registered practitioners who use these practices must give patients a written copy of that same bill of rights. It carries no scope qualifier.

Both provisions are on the books. Nothing read for this article settles which one controls. If you see a licensed Minnesota clinician who offers complementary services, asking whether they provide the bill of rights is a fair question, and the honest answer may depend on how their board reads the law.

Categories shift, too. Under a 2026 Minnesota law, massage and Asian bodywork therapists can now choose to register with the state. Starting January 1, 2028, the labels RMT and RABT, short for registered massage therapist and registered Asian bodywork therapist, are reserved for people who do. Massage by someone who hasn’t registered remains legal under chapter 146A. When part of a field moves from the unlicensed column toward a regulated one, the paperwork you’re owed can change with it.

Licensed complementary professions follow different rules

Once a practice is licensed, its consent duties come from its own practice act and board. Some of those boards ask for exactly what the safe-harbor forms leave out.

California’s Board of Chiropractic Examiners adopted a regulation, effective October 7, 2011, requiring chiropractors to tell each patient, both out loud and in writing, about the material risks of proposed care. Material means a procedure that inherently carries a known risk of serious bodily harm. Written consent must come before care begins, and a violation counts as unprofessional conduct.

Utah requires a licensed acupuncturist’s patient chart to include a signed statement consenting to acupuncture. When the acupuncturist offers an adjunctive therapy, the chart must also hold a signed disclosure of the acupuncturist’s education and training for that particular therapy. Records are kept seven years.

Mississippi’s acupuncture rules, last amended March 16, 2017, require the practitioner to tell patients that acupuncture is no substitute for conventional medical diagnosis and treatment. They also require an evaluation by a licensed physician before acupuncture begins.

The neck manipulation dispute

The sharpest test of risk disclosure in a licensed complementary profession involves the neck. In a scientific statement published in August 2014, the American Heart Association and American Stroke Association said patients should be told about the statistical association between neck manipulation and cervical artery dissection before the procedure. A cervical artery dissection is a tear in the wall of a neck artery that can lead to stroke. The same statement says biomechanical evidence is insufficient to show that manipulation causes these tears. It is a scientific statement written for health professionals, not a clinical practice guideline.

Connecticut’s Board of Chiropractic Examiners had taken the opposite position four years earlier. Its declaratory ruling of June 10, 2010, held that chiropractors are not required to address stroke or dissection when securing consent. The ruling itself wasn’t read for this article. It’s reported here through a 2025 review in the Journal of Contemporary Chiropractic by two chiropractors, Steve Brown and Robert Cooperstein, who argue the ruling isn’t supported by the evidence and urge the board to look at it again.

California’s 2011 rule, meanwhile, requires disclosure of material risks without naming stroke at all. Whether manipulation causes these tears is argued out in the library’s chiropractic stroke analysis. The consent point here is narrower: two official bodies gave opposite answers to whether the risk belongs in the conversation at all.

Reading the sheet before you sign

The form tells you what the practitioner is. You have to ask for the rest. Here is a short way to sort it.

What the form already answers. Whether the practitioner is licensed. What the service is and the theory behind it. Their training, as they describe it. Fees. In Minnesota, Rhode Island and New Mexico, where to complain.

What you’ll have to ask.

1. What can go wrong with this specific practice, and what have you seen happen to clients?
2. What will you do if I feel faint, overheated, dizzy or unwell during a session?
3. Do you carry liability insurance? Colorado makes practitioners tell you. Elsewhere, you’ll need to ask.
4. Which health conditions make you send someone to a licensed clinician before working with them?
5. May I keep a copy of what I’m signing? In California, the law says you get one.

Signs the conversation belongs with a licensed clinician. The practitioner names a disease they say you have. They suggest reducing or stopping a prescribed medicine, or imply your doctor doesn’t need to know what you’re doing. Those are the acts several of these statutes forbid. Any question about changing prescribed treatment goes to the clinician who prescribed it. A practitioner who crosses those lines can be reported to the state office named on your form or to your state attorney general’s consumer protection division.

Symptoms that are new, worsening or frightening belong with a licensed clinician regardless of what practice you’re using. So does anything that happens during a session that leaves you hurt, faint or confused.

The Takeaway

Treat the signed sheet as a statement of status, not an account of risk. It tells you the person in front of you isn’t licensed, what they believe they’re doing, and what they say qualifies them. In the states that require these forms, it often also tells you where to complain, which matters more than it seems in a system with few enforcers.

What it won’t tell you is what could go wrong, because none of the seven state laws verified here requires it to. That part of the conversation happens only if you start it, and the five questions above are a reasonable way to begin.

Sources

1. Minnesota Office of the Revisor of Statutes. “Minn. Stat. 146A.11, Complementary and Alternative Health Care Client Bill of Rights (enacted 2000 c 460; amended 2007, 2008, 2013, 2014, 2016).” revisor.mn.gov
2. Minnesota Office of the Revisor of Statutes. “Minn. Stat. 146A.065, Complementary and Alternative Health Care Practices by Licensed or Registered Health Care Practitioners (2014 c 291 art 4 s 2).” revisor.mn.gov
3. Minnesota Office of the Revisor of Statutes. “Minn. Stat. 146A.01, Definitions (22 listed practices; exclusions; no medical diagnosis or recommending discontinuance of prescribed treatment).” revisor.mn.gov
4. Minnesota Office of the Revisor of Statutes. “Minn. Stat. 146A.08, Prohibited Conduct.” revisor.mn.gov
5. Minnesota Office of the Revisor of Statutes. “Laws of Minnesota 2026, Chapter 115 (optional registration for massage therapists and Asian bodywork therapists; protected titles RMT and RABT effective January 1, 2028; unregistered practice not prohibited; related 146A provisions effective July 1, 2028).” revisor.mn.gov
6. Minnesota Department of Health, Office of Unlicensed Complementary and Alternative Health Care Practice. “Biennial Report, July 1, 2002 to June 30, 2004.” health.mn.gov
7. Minnesota Department of Health, Office of Unlicensed Complementary and Alternative Health Care Practice (via Minnesota Legislative Reference Library). “Biennial Report, July 1, 2008 to June 30, 2010 (September 2010).” lrl.mn.gov
8. Minnesota Department of Health. “Office of Unlicensed Complementary and Alternative Health Care Practice (page last updated July 31, 2024).” health.mn.gov
9. State of Rhode Island General Assembly. “R.I. Gen. Laws 23-74-14, Unlicensed health care client bill of rights (P.L. 2002, ch. 133).” webserver.rilegislature.gov
10. FindLaw, mirror of the California Business and Professions Code (current as of January 1, 2026). “Cal. Bus. & Prof. Code 2053.5.” codes.findlaw.com
11. FindLaw, mirror of the California Business and Professions Code (current as of January 1, 2026). “Cal. Bus. & Prof. Code 2053.6.” codes.findlaw.com
12. FindLaw, mirror of the California Business and Professions Code. “Cal. Bus. & Prof. Code 2052 (unlicensed practice of medicine; penalties).” codes.findlaw.com
13. California Legislature (legacy bill archive). “SB 577 (Burton), as amended in Assembly June 28, 2002, Section 1 legislative findings.” leginfo.ca.gov
14. New Mexico Legislature. “House Bill 664 (2009), Unlicensed Health Care Practice Act, final text, effective July 1, 2009.” nmlegis.gov
15. Colorado Legislative Council Staff (fiscal note hosted by StateBillInfo). “Final Fiscal Note, SB13-215, Alternative Health Care Practitioners, July 1, 2013.” statebillinfo.com
16. Maine Legislature. “32 M.R.S. 12602, Disclosure requirements (PL 2019, c. 265).” legislature.maine.gov
17. Idaho Legislature. “Idaho Code 54-1804, Unlicensed practice, subsection (1)(l).” legislature.idaho.gov
18. Louisiana State Legislature. “La. R.S. 37:1742.1, Disclosure (Acts 2005, No. 334; amended 2006, 2008, 2018).” legis.la.gov
19. The 194th General Court of the Commonwealth of Massachusetts. “Bill S.1481, An Act providing for consumer access to and the right to practice complementary and alternative health care services (filed January 17, 2025).” malegislature.gov
20. The 194th General Court of the Commonwealth of Massachusetts. “Bill S.1481, bill history (reported favorably by the Joint Committee on Public Health and referred to Health Care Financing, October 14, 2025; accompanied study order S2931, January 29, 2026; checked October 21, 2026).” malegislature.gov
21. The 194th General Court of the Commonwealth of Massachusetts. “Senate Order S2931, authorizing the Joint Committee on Health Care Financing to make an investigation and study of Senate documents including S.1481 (January 29, 2026).” malegislature.gov
22. National Health Freedom Action (advocacy group), testimony filed with the North Dakota Legislative Assembly. “Diane M. Miller, JD, testimony on HB 1472, January 29, 2021.” ndlegis.gov
23. Science-Based Medicine (opinion). “Jann Bellamy, article on safe-harbor ('Quack Protection Act') bills proposed in state legislatures, April 8, 2021.” sciencebasedmedicine.org
24. California Board of Chiropractic Examiners. “Notice: Informed Consent, 16 CCR 319.1, effective October 7, 2011.”
25. Legal Information Institute, Cornell Law School (mirror of the Utah Administrative Code). “Utah Admin. Code R156-72-302c, Informed Consent (acupuncture).” law.cornell.edu
26. Mississippi State Board of Medical Licensure. “Part 2625, The Practice of Acupuncture (adopted January 20, 2000; last amended March 16, 2017).” msbml.ms.gov
27. Stroke. “Biller J, Sacco RL, et al. "Cervical arterial dissections and association with cervical manipulative therapy: a statement for healthcare professionals from the American Heart Association/American Stroke Association." Stroke, 2014 (online August 7, 2014). PubMed. DOI: 10.1161/STR.0000000000000016.” pubmed.ncbi.nlm.nih.gov
28. Journal of Contemporary Chiropractic. “Brown S, Cooperstein R. "The Connecticut Law on Chiropractic Informed Consent to Cervical Artery Dissection and Stroke: A Narrative Review." J Contemp Chiropr 2025;8(1):162-169, published June 2, 2025 (reports the Connecticut Board of Chiropractic Examiners' declaratory ruling of June 10, 2010).” journal.parker.edu
29. Seminars in Oncology. “Monaco GP, Smith G. "Informed consent in complementary and alternative medicine: current status and future needs." Semin Oncol, 2002. PubMed. DOI: 10.1053/sonc.2002.50010.” pubmed.ncbi.nlm.nih.gov