MCMULLEN CHIROPRACTIC CLINIC

NOTICE TO PATIENTS

PROCEDURE FOR REQUESTING YOUR HEALTH RECORDS
(Sec 181.105 HEALTH & SAFETY CODE - CHP 181)
1 - you must sign a request for medical records form - we have the form - ask the receptionist for one
2 - You must list the specific information or records to be disclosed; and the person to whom the records are to be disclosed. TBCE Rule 76.2(c)
3 - We have 15 business days after receiving the applicable fee to provide the records TBCE Rule 76.2(h)

LICENSING AND DISCIPLINARY AUTHORITY
TEXAS BOARD OF EXAMINERS
1801 Congress Avenue
Ste. 3-825
Austin, Texas 78701-1319
Phone 512 - 305 - 6700
Email:: tbce@tbce.texas.gov

FILE A COMPLAINT AT
TEXAS BOARD OF EXAMINERS
1801 Congress Avenue
Ste. 3-825
Austin, Texas 78701-1319
Phone 512 - 305 - 6700
1-800-821-3205
Email:: tbce@tbce.texas.gov