To obtain your records, or your child’s records, please follow the steps below:

Submit a written request

• Via Email: Email your written request and completed Authorization form to: teana@blendedresourcestexastherapy.com
  • Subject line: “REQUEST FOR RECORDS”

Additional requirements (if applicable):

• Litigation-related records If records are requested for use in litigation, please include:
  • Cause number
  • Case title
  • Court where the case is pending
• Business Records Affidavit
  • If you require a Business Records Affidavit, indicate this in your request
  • Fee: $15
  • Affidavits will not be provided until payment is received
• Records fee
  • Fee for providing records: $25 for electronic records
  • Accepted payment methods: credit cards, or cash.
  • Texas law does not require records to be released until fees are paid
• Couples, family, or third-party records If you are requesting:
  • Couples counseling records
  • Family counseling records
  • Records for anyone other than yourself or your child

  State and federal law require either:

  • A valid Court Order, or
  • 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

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:

1. In response to a valid court or administrative tribunal order, or
2. When the individual (or parent/legal guardian):
   • Is a party to the proceeding
   • Has notice that the PHI has been requested
   • Does not object to the disclosure

   An Authorization from the individual or parent satisfies this requirement.

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:

• A “Statement of Assurance” will not be accepted
• A valid Authorization or Court Order will be required