Evolve Holistic Center

Patient notice

Your Health Records and Your Rights

Posted in accordance with Texas House Bill 4224 (Health and Safety Code Section 181.105)

Texas law requires us to post clear instructions for requesting your health care records, contacting our licensing authority, and filing a consumer complaint. If you need help with any of these steps, just ask and we'll assist you.

A. How to Request Your Health Care Records

You have the right to access and receive copies of your health care records from this practice.

  1. Submit your request through the secure patient portal (log in and send a message requesting your records), by email to jason@evolveholisticcenter.com, by mail to 5801 Curzon Ave, Ste 213, Fort Worth, TX 76107, or in person. Call 817-313-8026 if you'd like help starting your request.
  2. Include your full name, date of birth, the specific records or dates of service you need, and the person to whom the records should be sent. Written requests must be signed by you or your legally authorized representative.
  3. We verify identity before releasing records. A parent, legal guardian, or authorized representative may request records on a patient's behalf with appropriate documentation.
  4. Records are provided within 15 business days from the date of the request, after any applicable fees are received, as required by TBCE Rule §76.2. Fees are reasonable and cost-based, and you'll be notified of any fee before records are prepared. Records are never withheld because of an outstanding balance.

B. How to Contact Our Licensing Authority

Dr. Jason Dixon, DC (TBCE License #12971) is licensed and regulated by the Texas Board of Chiropractic Examiners (TBCE).

  • Website: www.tbce.texas.gov
  • Phone: 512-305-6700 or toll-free 800-821-3205
  • Mail: Texas Board of Chiropractic Examiners, 1801 Congress Avenue, Suite 10.500, Austin, TX 78701

C. How to File a Consumer Complaint

If you have a concern about your care or how your health information was handled, you may file a complaint with either of the following:

Texas Board of Chiropractic Examiners: visit tbce.texas.gov and select Complaint Information to submit online, or download the form and submit by mail, email, or fax. Include dates, names, and a description of your concern.

Office of the Texas Attorney General (for privacy-related complaints as described by Texas Health and Safety Code Section 181.103): file online at texasattorneygeneral.gov/consumer-protection/file-consumer-complaint.