Access to Health Records

Notice: Your Rights Regarding Health Records & Complaints

In accordance with Texas Health and Safety Code Sec. 181.105, this facility provides the following information regarding your access to protected health information and the process for filing complaints.

1. How to Request Your Health Care Records

You have the right to inspect or obtain a copy of your health records. To exercise this right, please follow these instructions:

• Written Request: Submit a formal request in writing to [Insert Your Name or Practice Name].
• Submission Method: You may deliver your request via email to [Insert Email Address], by mail to [Insert Physical Mailing Address], or in person during office hours.
• Format: Please specify if you prefer a digital copy or a paper copy.
• Timeline: We will respond to your request within 15 business days of receipt, as required by Texas law.

2. Contacting Regulatory Authorities

If you have questions or concerns regarding my professional conduct or licensing, you may contact the state regulatory board:

• Authority: Texas State Board of Examiners of Professional Counselors (under the Texas Behavioral Health Executive Council).
• Website: www.bhec.texas.gov
• Mailing Address: 1801 Congress Ave., Ste. 7.300, Austin, Texas 78701
• Phone: (512) 305-7700

3. Filing a Consumer Complaint

If you believe your privacy rights have been violated or wish to file a complaint regarding the handling of your health records:

• Internal Complaint: Please first contact [Your Name/Practice Manager] at [Phone Number/Email] so we can attempt to resolve the issue immediately.
• State Complaint (Texas Attorney General): You may file a complaint with the Office of the Attorney General of Texas regarding violations of the Texas Medical Records Privacy Act.

• Website: www.texasattorneygeneral.gov
• Phone: (800) 621-0508