How to Request Records
Texas law requires that requests for mental health records be submitted in writing. To request your records, or your child’s records, please follow the instructions below.
How to submit a request:
- Complete our HIPAA-compliant Authorization and submit it through the patient portal in SimplePractice, our electronic health records system.
- In the subject line, please write: “REQUEST FOR RECORDS.”
- Clearly specify which records are being requested and include the name, address, and/or email address of the intended recipient.
If you do not have access to the patient portal:
- Email your completed Authorization and written request to:
- records@riverbend-counseling.com
- Subject line: “REQUEST FOR RECORDS.”
Additional requirements (if applicable):
- If records are requested for litigation, please include full case details, including the cause number, case title, and court.
- If a Business Records Affidavit is required, note this in your request.
Fees:
- Records fee: $35
- Business Records Affidavit fee: $15 (affidavit provided only after payment)
- Accepted payment methods: Credit / Debit Card
Texas law does not require records to be released until all applicable fees have been paid.
Requests for couples, family, or third-party records require either:
- A Court Order, or
- An Authorization signed by the individual (or parent) whose records are being requested.
Instructions for Attorneys & Document Companies
A subpoena alone is not sufficient to compel the release of confidential mental health records, billing records, or protected health information (PHI) under HIPAA.
Records may be released only:
- In response to a court or administrative order, or
- With a valid Authorization signed by the individual or parent.
If a client or parent has declined release, a “Statement of Assurance” will not be accepted. A valid Authorization or Court Order is required.
Complaints
You have a right to have your complaints heard and resolved in a timely manner. If we
cannot work things out to your satisfaction, you may file a complaint with our licensing
board:
Texas Behavioral Health Executive Council
1801 Congress Avenue, Suite 7.300
Austin, TX 78701
Link to Complaint Form: http://www.bhec.texas.gov/wp-content/uploads/2020/07/BHEC-Complaint-Form.pdf.
Telephone: 1-800-821-3205
If you have a complaint concerning the HIPAA Privacy Regulations, you may contact the
U. S. Department of Health and Human Services, Office for Civil Rights, at:
If you believe that you have a Consumer Complaint regarding the privacy and security
of your health information, you may contact the Texas Office of the Attorney General
and file a consumer complaint by clicking this link:
TexasattorneygeneralPatient Privacy | Office of the Attorney General
HIPAA Notice of Privacy Practices
To review how your protected health information may be used and disclosed, please view our HIPAA Notice of Privacy Practices.