Release of Records

Patient Records & Consumer Information

At HealthWorks Family Chiropractic, we want patients to have clear, easy access to
information about requesting records, contacting our licensing board, and filing
consumer complaints.

Requesting or Releasing Medical Records

Patients may request copies of their records or authorize HealthWorks to send
records to another provider, office, or individual.

Requests may be made by:

● Calling our office at 972-612-1800
● Emailing Care@HealthWorksTX.com
● Visiting our front desk in person
Completing a records release form (Download PDF)

To help us process your request, please include:
● Patient name
● Date of birth
● Where the records should be sent

Most records requests are processed within 15 business days. Requests are handled
in accordance with applicable Texas and federal laws.

HealthWorks Family Chiropractic does not charge copy fees for standard medical
records requests.

Chiropractic Licensing Authority

HealthWorks Family Chiropractic is regulated by the Texas Board of Chiropractic
Examiners.

Texas Board of Chiropractic Examiners
1801 Congress Avenue, Suite 10.500

Austin, TX 78701
Phone: 512-305-6700
Website: tbce.texas.gov

Patients may contact the TBCE regarding licensing matters or complaints involving
chiropractic care.

Consumer Complaints

If you have questions or concerns about your experience with our office, we
encourage you to contact us directly so we can try to help.

Patients may also file a consumer complaint with the Texas Attorney General
Consumer Protection Division.

Online complaint information is available through the Texas Attorney General’s
Consumer Protection website. The AG’s Consumer Protection hotline is
1-800-621-0508.


Release of Records Form

"*" indicates required fields

MM slash DD slash YYYY
MM slash DD slash YYYY
I,
authorize HealthWorks Family Chiropractic to release my medical records to
Address*
Clear Signature
MM slash DD slash YYYY

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