Patient Notice

Patient Notice Regarding Access to Records & Privacy Complaints

How to receive your medical records.

You may request a copy of your medical records during normal business hours. To receive a copy of your medical records, you must contact Jillian Vogel by email at connect@caminorestorativecounseling.com. You will be given a medical record request form to complete.

• Be very specific about the information you need to have released. Indicate dates of service, types of visits and what parts of the record you need.
• Sign and date the authorization using your full legal signature. We only allow handwritten signatures, electronic signatures are not allowed.
• Please be sure to include your telephone number so we can contact you, if we have questions regarding your request.
• The request may take up to 15 days to process.

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How to file Complaints.

If you believe your protected health information has been or may have been used or disclosed in violation of the Texas Medical Records Privacy Act you may file a complaint with Texas Medical Board or the Texas Attorney General’s Consumer Protection Division.

Texas Behavioral Health Executive Council

The Texas Behavioral Health Executive Council consists of the Texas State Board of Examiners of Marriage and Family Therapists, Texas State Board of Examiners of Professional Counselors, Texas State Board of Examiners of Psychologists, and the Texas State Board of Social Worker Examiners.

Complaints regarding:

• Psychologists (e.g., LP, LPA, or LSSP)
• Professional Counselors (e.g., LPC or LPCA)
• Marriage and Family Therapists (e.g., LMFT OR LMFTA)
• Social Workers (e.g., LCSW, LMSW, or LBSW)

Complaints must be in writing and on the Board’s approved complaint form. The complaint may be submitted by mail or email. Obtain the form by downloading and printing from the website or by requesting by phone or in writing.

• Website: https://www.bhec.texas.gov/discipline-and-complaints
• Email: Enforcement@bhec.texas.gov
• Phone: (512) 305-7700 or 1 (800) 821-3205
• Mail:
  Texas Behavioral Health Executive Council
  Attn: Enforcement Division
  1801 Congress Ave., Ste. 7.300
  Austin, Texas 78701

The Texas Attorney General's Consumer Protection Division

Complaints must be in writing and on the Attorney General’s approved complaint form. The complaint must be submitted online. Obtain the form by accessing the online complaint portal.

• Website: https://www.texasattorneygeneral.gov/consumer-protection/file-consumer-complaint
• Phone: (800) 621-0508
• Mail:
  Office of the Attorney General
  PO Box 12548
  Austin, Texas 78711-2548