Patient Rights: How to Request Your Records, Contact Our Licensing Board, and File a Complaint

Posted in compliance with Texas Health and Safety Code § 181.105.

Active Spine & Sport Therapy is committed to your right to access your health information and to a transparent process if you have concerns about your care.

1. How to Request Your Health Care Records

You have the right to obtain copies of your health care records held by Active Spine & Sport Therapy. To request your records:

  1. Submit a written, signed, and dated request. Include:

    • Your full name and date of birth

    • Current address, phone number, and email

    • The dates of service or specific records you are requesting (e.g., "all records from January 2024 to present" or "treatment notes from my July 12, 2025 visit")

    • Whether you want the records sent to you, to another provider, or to a third party (and that recipient's address)

    • Your signature

  2. Send your request by one of the following methods:

    • Email: info@activespineandsport.com

    • Mail: Active Spine & Sport Therapy, 3600 Hulen Street, Suite A4, Fort Worth, TX 76107

    • In person: Hand-deliver to our front desk during business hours

  3. Verification. We may ask you to confirm your identity before releasing records.

  4. Timing. We will provide your records within 15 business days of receiving your written request, as required by Texas law.

  5. Fees. A reasonable, cost-based fee may apply for copying, mailing, or electronic delivery, consistent with state and federal law. We will notify you of any fee before fulfilling the request.

If you have questions about the process, call us at (817) 332-5353.

2. How to Contact Our Licensing and Disciplinary Authority

Active Spine & Sport Therapy and its doctors of chiropractic are licensed and regulated by the Texas Board of Chiropractic Examiners (TBCE).

3. How to File a Consumer Complaint

You may file a complaint with the Texas Board of Chiropractic Examiners, the Texas Attorney General, or both.

A. File a Complaint with the Texas Board of Chiropractic Examiners

  1. Obtain the official complaint form by one of the following methods:

  2. Complete the form in writing. Include:

    • Your full name and contact information

    • The name of the chiropractor or clinic involved

    • The date(s) of the event(s)

    • A detailed description of the conduct or treatment you are complaining about

  3. Submit your completed complaint by one of the following:

  4. Note: TBCE does not accept anonymous complaints. You will receive written acknowledgment that your complaint has been received.

B. File a Complaint with the Texas Attorney General (Privacy / Medical Records)

If your complaint involves the privacy of your protected health information or your right to access your medical records under the Texas Medical Records Privacy Act:

  1. Visit: https://www.texasattorneygeneral.gov/consumer-protection/file-consumer-complaint

  2. Select the "Privacy" complaint form for issues involving misuse, unlawful sharing, or improper handling of your personal or health information. Use the "General" complaint form for other consumer concerns.

  3. Complete the form with the name of the business, the dates and details of the issue, and any communications you have already had with us.

  4. Additional consumer information is available on the Attorney General's Consumer Information Website maintained under Texas Health and Safety Code § 181.103.

C. File a Complaint with the U.S. Department of Health and Human Services (HIPAA)

For complaints involving federal HIPAA privacy or security rights:

Last updated: May 13, 2026.