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8300 Floyd Curl Dr. San Antonio, Texas 78229 Phone: 210-450-9760 Fax: 210-450-6058 Patient Authorization for Release of Health Records to External Parties 1. I authorize Phone: Fax: to disclose information.

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(b) Deadline for Release of Records. The requested copies of medical and/or billing records or a summary or narrative of the records shall be furnished by the physician within 15 business days after the date of receipt of the request and reasonable fees for furnishing the information.

How do I get my medical records? Put your request in writing and send it to the physician's address listed on the physician's Profile on the TMB website. You can also contact the TMB to determine if a custodian of records has been reported.

(b) Deadline for Release of Records. The requested copies of medical and/or billing records or a summary or narrative of the records shall be furnished by the physician within 15 business days after the date of receipt of the request and reasonable fees for furnishing the information.

In Texas you have the right to: See and get a copy of your medical record. within 15 business days after they receive your request and payment for copies ("business days" do not include weekends).

Requests may come in the form of a subpoena. (There are four possible responses when a subpoena is received.) The subpoena must be accompanied by a medical authorization signed by the patient. These subpoenas are generally issued by an attorney's office. Ask for an authorization in most cases.

Copy Fees for Medical Records in an Electronic Format For medical records provided in an electronic format, the rules provide that physicians may charge no more than $25 for 500 pages or fewer and $50 for more than 500 pages.

The Department of State Health Services is committed to providing full access to public information. To request records under the Texas Public Information Act: Submit a request in writing via U.S. Mail, fax or email. Include contact information and a clear description of the records you are requesting.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
Content Takedown Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232