House Bill 4224

Notice Regarding Access to Protected Health Information and Filing Complaints:

As a client of our office, you have a right to your treatment record and information. To
request a copy of your record with our office, please send a written request to our office
at 3939 W. Green Oaks Blvd., Suite 206, Arlington, Texas 76016 or at dr.donnacampbell@psychscf.com.

Further, if you believe your rights have been violated or your care has been compromised, you may file a
complaint with the Texas Behavioral Health Executive Council (TBHEC), which licenses mental health professionals in Texas. For information on how to file a complaint and to access complaint forms, please visit the BHPEC website at:
https://www.bhpec.texas.gov. Complaints may also be submitted in writing to the BHPEC at 1801 Congress Avenue, Suite 7.300 Austin, Texas 78701.