Patient Records Requests

To request copies of health care records, please complete the steps:

Step 1: Download and complete the Release of Information form below

Step 2: Email the completed form to: records@ccfam.com 

To protect your confidentiality, ensure accuracy, and timely processing: 

• Records will be released within 15 days after receipt of a correctly completed Release of Information form and resolution of any applicable fees or account balances.  

• If requested records do not exist or cannot be located, we will notify the requestor. 

CCFAM follows the Texas Health and Safety Code regarding access to mental health records. 

• A reasonable fee may be charged for retrieving or copying records. 

• A fee will not be charged when records are requested by a patient or the patient’s attorney for the purpose of applying for or appealing disability or Social Security benefits, as required by Texas law. 

• Fee details for record requests are outlined in our Financial Policies. 

• Behavioral Health Executive Council (BHEC): Visit their  Contact Us  webpage for licensing or regulatory questions.
• Texas Office of the Attorney General – Consumer Protection: Visit their Consumer Protection webpage to file a consumer complaint.