Each Individual Adult Must Submit:
Parent sessions--a parent intake session and once-a-month check-ins--are required.
Each Parent/Adult Must Submit:
Child/Adolescent:
Please note that submitting these forms does not guarantee you an appointment with your preferred provider. You will need to contact our office manager to confirm the provider and appointment time.
In accordance with Texas law (House Bill 4224 and Section 181.105 of the Texas Health and Safety Code), the following information is provided to help consumers understand their rights and available resources.
Requesting Your Health Care Records
You have the right to request a copy of your mental health records. To request your records, please submit a written request to your treating clinician or to the practice directly. Requests may be made via email. Records will be provided in accordance with Texas law and applicable privacy regulations. If you have questions about accessing your records, please contact our office for assistance.
Contacting the Texas Behavioral Health Executive Council (BHEC)
The Texas Behavioral Health Executive Council regulates licensed mental health professionals in Texas. If you have questions about licensure or professional standards, you may contact BHEC directly:
Texas Behavioral Health Executive Council – Contact Us
https://bhec.texas.gov/contact-us/
Filing a Consumer Complaint
If you wish to file a consumer complaint regarding mental health services, you may do so with the Texas Office of the Attorney General:
Office of the Attorney General – Consumer Protection
https://www.texasattorneygeneral.gov/consumer-protection
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