Consumer Rights & Medical Records Access
Consumer Rights
Adamantine Psychotherapy and Counseling Services is committed to protecting your privacy and your right to access your health records in accordance with federal HIPAA regulations and applicable state laws in Texas, Florida, and Alabama.
This page explains how to request medical records, what information is required, applicable fees, and how to file a complaint if needed.
Licensed Provider Information
Adamantine Psychotherapy and Counseling Services is licensed to provide services in the following states:
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Texas – License #87936
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Alabama – License #LPC05471
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Florida – License #TPMC5478
Requesting Medical Records
You or your authorized representative may request copies of medical records by submitting a written request.
All requests should be sent to:
info@adamantinepsychotherapy.com
Our administrative team will ensure the request is routed to the appropriate therapist.
Information Required for Processing
To avoid delays, requests must include all of the following:
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Full legal name of the client
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Date of birth
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Phone number
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Email address
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Date(s) of service requested
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Type(s) of records requested (clinical notes, assessments, billing records)
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Preferred delivery method (email, mail, or fax)
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If records are sent to a third party:
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Recipient’s full name
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Relationship to the client
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Email address and/or fax number
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Signature of the client or authorized representative
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Date of request
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Incomplete requests may delay processing.
Medical Records Access Fee Policy
We follow federal HIPAA Privacy Rules and applicable state laws regarding fees for medical record copies.
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Fees apply per request
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Fees apply to electronic, faxed, and mailed paper copies
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Fees must be paid before records are released
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Retrieval, search, or handling fees are not charged for patient-requested access under HIPAA
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Written fee estimates are available upon request
Texas Fee Schedule
Electronic copies (email or electronic format):
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$25 for records up to 500 pages
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$50 for records exceeding 500 pages
Paper copies (mailed):
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$25 for the first 20 pages
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$0.50 per page thereafter
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Postage billed at actual cost
Faxed copies:
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Charged at paper-copy rates
Affidavit (if requested):
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$15 maximum charge
Florida Fee Schedule
Electronic copies (email or electronic format):
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Hospital-based records: $2.00 per page
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Physician/provider records:
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$1.00 per page for the first 25 pages
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$0.25 per page thereafter
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Paper copies (mailed):
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Hospitals: $1.00 per page
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Physicians:
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$1.00 per page for the first 25 pages
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$0.25 per page thereafter
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May include $1.00 per year of medical records searched (hospital rule only)
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Postage billed at actual cost
Faxed copies:
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Charged at paper-copy rates listed above
Alabama Fee Schedule
Electronic copies (email or electronic format):
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$1.00 per page for the first 25 pages
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$0.50 per page for each additional page
Paper copies (mailed):
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$1.00 per page for the first 25 pages
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$0.50 per page thereafter
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Postage billed at actual cost
Faxed copies:
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Charged at paper-copy rates listed above
Although Alabama permits a search fee, Adamantine Psychotherapy does not charge retrieval or search fees for patient-requested access in accordance with HIPAA.
Payment & Processing
Fees must be paid in full prior to the release of records. Records may be delayed if payment is not received.
Filing a Complaint or Contacting Regulatory Agencies
Texas clients may contact the Texas Behavioral Health Executive Council or file a consumer complaint with the Texas Office of the Attorney General.
Texas Behavioral Health Executive Council (BHEC):
https://www.bhec.texas.gov/contact-us/
Texas Attorney General – Consumer Protection:
https://www.texasattorneygeneral.gov/consumer-protection/file-consumer-complaint
Summary Notice
We comply with Texas, Florida, and Alabama law and charge the maximum allowable fee for electronic, mailed, or faxed medical record copies, including applicable page-based charges and postage.