How to Request Your Health Care Records

Submit Your Request

Requests can be made in the following ways:

• In Writing: Complete a Records Release Authorization form (available by request)

• By Email: Send your request to eliana@1135counseling.com

• By Mail: Send your written request to the address below

Required Information

Your request must include:

• Your full name (as it appears in your records)

• Date of birth

• Valid photo identification

• Specific records requested (date range, type of records)

• Preferred format (paper copies or electronic)

• Your signature and date

Processing Timeline & Fees

We will respond to your request within 15 business days as required by Texas law. There may be reasonable copying and mailing fees as permitted under state and federal regulations. We will inform you of any applicable fees before processing your request.

Contact for Records Requests:

Address: 6301 Gaston Avenue, Suite 1220, Dallas, TX 75214

Email: eliana@1135counseling.com

Phone: (214) 945-4814‬

Office Hours: Monday to Friday: 10am-5pm

Contact Your Licensing Authority

Our practice is regulated by the Texas Behavioral Health Executive Council (BHEC). You may contact BHEC for information about our licensure status, professional standards, or to file a complaint regarding professional conduct.

Texas Behavioral Health Executive Council (BHEC)

Website: bhec.texas.gov

Physical Address: 1801 Congress Ave., Suite 7.300, Austin, TX 78701

Mailing Address: P.O. Box 141369, Austin, TX 78714-1369

Phone: (512) 305-7700

Email: info@bhec.texas.gov

What BHEC Can Help With:

• Verify current licensure status

• File complaints about professional conduct or ethics violations

• Obtain information about professional standards and regulations

• Report concerns about practice quality or safety

How to File a Consumer Complaint

If you have concerns about our services, billing practices, privacy issues, or other consumer-related matters, you have the right to file a complaint with the following agencies:

Texas Behavioral Health Executive Council

For complaints related to professional conduct, ethics, or licensure issues:

File a Complaint with BHEC

Online: bhec.texas.gov/consumers/file-a-complaint/

By Mail: Download complaint form from website and mail to address above

Phone: (512) 305-7700 for assistance with the complaint process

Texas Attorney General - Consumer Protection Division

For complaints related to unfair business practices, billing disputes, or consumer rights violations:

File a Complaint with Texas Attorney General

Online: texasattorneygeneral.gov/consumer-protection/file-consumer-complaint

By Phone: (800) 621-0508 (toll-free in Texas)

By Mail: Office of the Attorney General, Consumer Protection Division P.O. Box 12548 Austin, TX 78711-2548

Important: Filing a complaint does not prevent you from seeking other legal remedies. You may also wish to consult with an attorney regarding your rights and options.

This notice is provided in compliance with Texas Health and Safety Code Section 181.105.

Last Updated: January 2026