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Texas Patient Rights Notice

In accordance with Texas House Bill 4224 and Texas Health and Safety Code §181.103, the following information is provided to help consumers understand their rights and available resources.

Requesting Access to Your Health Care Records

You have the right to inspect or obtain a copy of your health care records maintained by this practice. To request access to your records, submit a written request that includes:

• Your full name
• Your date of birth
• A description of the records requested
• Dates of service, if known
• Where the records should be sent

Requests may be submitted by one of the following methods:

Secure client portal message
Email: jason@patternshiftcounseling.com
Mail: Pattern Shift Counseling, 4525 N. Central Expy #490, Dallas, TX 75205

Identity verification may be required before records are released. Records will be provided in accordance with applicable Texas law and federal privacy regulations. A reasonable cost based fee may apply as permitted by law.

Professional Licensing Authority

Licensed Professional Counselors in Texas are regulated by the Texas Behavioral Health Executive Council.

To obtain information about professional licensing or to file a complaint regarding a license holder, contact:

Texas Behavioral Health Executive Council
1801 Congress Avenue, Suite 7.300
Austin, Texas 78701

Phone: (512) 305 7700
Complaints Hotline: (800) 821 3205

Website: https://bhec.texas.gov

Filing a Consumer Complaint Regarding Health Information Privacy

You have the right to file a complaint regarding the privacy of your health information under Texas Health and Safety Code §181.103.

A complaint may be submitted to the Texas Attorney General if you believe your health information privacy rights have been violated.

Complaints may be filed with the Office of the Attorney General of Texas at:

Office of the Attorney General of Texas
Office of the Attorney General
Consumer Protection Division
Phone: (800) 621 0508

Online complaint form:
https://www.texasattorneygeneral.gov/consumer-protection/file-consumer-complaint