[email protected]
529 Houston St Coppell, TX 75019
resilency brain health

Patient Rights & Requests

NOTICE TO PATIENTS

ACCESS TO HEALTH RECORDS & CONSUMER COMPLAINT INFORMATION

In accordance with Texas Health & Safety Code 181.105, patients are entitled to instruction regarding:
- Requesting medical records
- Contacting the applicable licensing authority
- Filing a consumer complaint

1. HOW TO REQUEST YOUR MEDICAL RECORDS

Step 1
Submit a written request to our office by:
- Email: [email protected]
- Fax: (469) 830-5730
- Mail: Resiliency Brain Health, 529 Houston St, Coppell, TX 75019
- In person during normal business hours
Step 2
Include the following information:
- Full Name
- Date of Birth
- Phone Number
- Date of Treatment requested
- Specific records requested
- Signature and date
Step 3
Provide a Copy of a valid government-issued photo ID
Step 4
Our office will process your request in accordance with applicable Texas Law and HIPAA regulations.
Reasonable copying and mailing fees may apply as permitted by law.
For questions regarding records request, contact our office at:
- Phone: (469)830-2090

2. HOW TO CONTACT THE CHIROPRACTIC LICENSING AUTHORITY

Texas Chiropractors are regulated by the:
Texas Board of Chiropractic Examiners
- Website: TBCE.com
- Phone: (512) 305-6700
- Mailing Address: Texas Board of Chiropractic Examiners, 333 Guadalupe Strett, Ste. 3-825, Austin, Texas 78701

You may contact the board regarding:
- Licensing questions
- Disciplinary matters
- Professional conduct concerns
- Filing complaint against a chiropractor

3. HOW TO FILE A CONSUMER COMPLAINT

Patients may file a consumer complaint regarding protected health information, privacy rights, or health care concerns under Texas Health & Safety Code 181.103.
Step 1
Visit the Texas Attorney General Consumer Protection Website.
Step 2
Complete the online complaint form or request a paper complaint form.
Step 3
Provide:
- Your contact information
- Name of the provider or facility
- Description of the complaint
- Relevant dates and supporting documents
Step 4
Submit the complaint through the Attorney General's Website or by mail.
PO BOX 12548
Austin, TX 78711-2548
Attorney General Consumer Protection Division
Phone: (800) 621-0508
This Notice is provided pursuant to Texas Health & Safety Code 181.103 and 181.05
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