Pursuant to TX House Bill 4224 Section 181.105 of the Texas Health and Safety Code, please be advised of the following:
- Quick Navigation:
- A. How to Request Health Care Records
- B. Disciplinary & Licensing Authority (TBCE)
- C. How to File a Consumer Complaint
A. HOW TO REQUEST ACCESS TO HEALTH CARE RECORDS FROM:
Peak Physical Medicine and Wellness
To request access to health care records:
- Contact Person: Office Manager
- How to Submit a Request: In person at the front desk or via email to info@peakphysicalmedicinetx.com using a completed/signed Records Request Release form.
- Information the Patient Must Provide:
- Full Legal Name and Date of Birth
- Current Phone Number and Mailing/Email Address
- Specific records or date ranges (e.g., examination notes, billing records, imaging reports)
- Format preference (electronic or paper copies)
- Signed patient signature (or authorized legal representative verification)
- Response Timeframe: In accordance with Texas state law, requests will be fulfilled within 15 business days of receiving a completed written request.
- Fees: As permitted by Texas and federal law, a reasonable, cost-based fee may apply for copying, supplies, and postage.
B. HOW TO CONTACT THE DISCIPLINARY/LICENSING AUTHORITY FOR:
Peak Physical Medicine and Wellness
- The name of the disciplinary/licensing authority is the Texas Board of Chiropractic Examiners (TBCE)
- Contact information for the Texas Board of Chiropractic Examiners (TBCE):
- Website: https://www.tbce.texas.gov
- Email: licensing@tbce.texas.gov
- Phone Number: (512) 305-6700
- Fax Number: (512) 305-6705
- Address: 1801 Congress Avenue, Ste. 10.500, Austin, Texas 78701-1319
C. HOW TO FILE A CONSUMER COMPLAINT AS DESCRIBED BY SECTION 181.103 OF THE TEXAS HEALTH AND SAFETY CODE:
- How to file a complaint under Texas Health and Safety Code Section 181.103:
https://www.texasattorneygeneral.gov/consumer-protection/file-consumer-complaint - Where to file a complaint under Texas Health and Safety Code Section 181.103:
https://www.texasattorneygeneral.gov/consumer-protection - You may file a privacy grievance or complaint directly with our clinic by contacting our Office Manager at (817) 882-6754, via email at Info@peakphysicalmedicinetx.com, or by mail/in person at 3200 Riverfront Dr. Ste 207, Fort Worth, TX 76107. You will not be penalized or retaliated against for filing a complaint.
If you have any questions regarding your rights or wish to initiate a request, please feel free to reach out to our team anytime.