How to File A Compliant
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:
Texas Behavioral Health Executive Council
1801 Congress Avenue, Suite 7.300
Austin, TX 7870
Telephone: 1-800-821-3205
Link to Complaint Form: http://www.bhec.texas.gov/wp-content/uploads/2020/07/BHEC-Complaint-Form.pdf.
Arizona:
Board of Behavioral Health Examiners
1740 W. Adams St., Suite 3600
Phoenix, AZ 85007
Phone: (602) 542-1882
Link to Complaint Form: https://bbhe.az.gov/sites/default/files/pdfs/Complaint%20Form%20Revised%2015-1212%20PDF%20Fillable.pdf
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: OCRMail@hhs.gov.
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:
https://www.texasattorneygeneral.gov/consumer-protection/health-care/patient-privacy
How do I request Mental Health Records?
Texas and Arizona law requires that requests for mental health records be made in writing.
To obtain your records, or your child’s records, please follow the steps below:
Submit a written request
Choose one of the following options:
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Via Patient Portal Complete our HIPAA-compliant Authorization form and submit it through the patient portal of our electronic health records system Sessions Health.
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Subject line: “REQUEST FOR RECORDS”
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Include:
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The specific records you are requesting
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The name, address, and/or email address of the intended recipient
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Via Email (if you do not have portal access) Email your written request and completed Authorization form to: ariana@arianadtherapy.com
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Subject line: “REQUEST FOR RECORDS”
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Additional requirements (if applicable):
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Litigation-related records If records are requested for use in litigation, please include:
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Cause number
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Case title
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Court where the case is pending
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Business Records Affidavit
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If you require a Business Records Affidavit, indicate this in your request
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Fee: $15
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Affidavits will not be provided until payment is received
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Records fee
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Fee for providing records: $25 for electronic records
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Accepted payment methods: credit cards, or cash.
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Texas and Arizona law does not require records to be released until fees are paid
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Couples, family, or third-party records If you are requesting:
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Couples counseling records
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Family counseling records
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Records for anyone other than yourself or your child
State and federal law require either:
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A valid Court Order, or
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An Authorization signed by the individual (or parent/legal guardian)
Relevant law: 45 C.F.R. §164.512(e); Texas Health & Safety Code §§611.004, 611.0045, 611.008
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Instructions for Attorneys and Document Companies
A subpoena alone is not sufficient to compel disclosure of confidential counseling or billing records, or other Protected Health Information (PHI), under HIPAA (45 C.F.R. Chapter 164).
For mental health or medical records requested or subpoenaed in litigation (including testimony), HIPAA permits disclosure only under the following circumstances:
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In response to a valid court or administrative tribunal order, or
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When the individual (or parent/legal guardian):
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Is a party to the proceeding
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Has notice that the PHI has been requested
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Does not object to the disclosure
An Authorization from the individual or parent satisfies this requirement.
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Relevant law: 45 C.F.R. §164.512(e)
Important Note
If the client or parent has indicated that they do not consent to release of records:
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A “Statement of Assurance” will not be accepted
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A valid Authorization or Court Order will be required