RESOURCES

Effective September 1, 2025, in compliance with Texas Health & Safety Code Section 181.105.

At Wildflower Pediatrics, we are committed to your privacy and your right to access your health information. Texas law requires us to provide clear instructions on how you can request your records, contact our licensing authority, or file a complaint.

1. How to Request Your Health Care Records

You have the right to inspect or obtain a copy of your health care records. To make a request, please follow these steps:

• Submit a Written Request: You must submit your request in writing to our Records Department.
• Information to Include: Please provide your full name, date of birth, the specific dates of service requested, and the specific information to be disclosed (e.g., “all records” or “lab results from June 2025”).
• Where to Send:
  • Email: frontdesk@wildflowerpediatrics.com
  • Mail: 11609 Anderson Mill Road Austin TX 78750
  • In-Person: Visit our front desk at [11609 Anderson Mill Road Austin TX 78750] to fill out an authorization form. *** Can you put a link to the attached form hB300 Authorization form****

Note: We may charge a reasonable, cost-based fee for copies as permitted by Texas law.

2. Contacting Our Licensing Authority

This practice is regulated by the state of Texas. If you have questions or concerns regarding our professional conduct or licensing, you may contact our oversight agency:

• For Physicians & Physician Assistants (Texas Medical Board)
  • Website: tmb.texas.gov
  • Complaint Hotline: (800) 201-9353
  • Mailing Address: P.O. Box 2018, Austin, TX 78768-2018
• For Nurses & Nurse Practitioners (Texas Board of Nursing)
  • Website: bon.texas.gov
  • Complaint Phone: (800) 821-3205 or (512) 305-6838
  • Mailing Address: 1801 Congress Avenue, Suite 10-200, Austin, TX 78701

3. How to File a Consumer Complaint

If you believe your privacy rights or rights to access your records have been violated, you have the right to file a formal complaint:

• With the Attorney General: You may file a complaint regarding medical records privacy with the Office of the Texas Attorney General via their Consumer Protection website.
• With Federal Authorities: You may also file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights (OCR).
• Internally: You may also contact our Privacy Officer directly at [Phone/Email] to resolve any concerns.

Notice of Electronic Disclosure of Protected Health Information

• In accordance with Texas Health & Safety Code Section 181.154
• This serves as notice that Wildflower Pediatrics maintains patient health information electronically. Texas law mandates notification that your Protected Health Information (PHI) may be subject to electronic disclosure.

Authorization Requirements

Under Texas and federal law, electronic disclosure of your health information generally requires a separate, specific authorization from you for each instance, which can be in written or electronic format.

Exceptions to Authorization

A separate authorization for electronic disclosure is not required in certain cases, including:

• Treatment: Sharing information with other healthcare providers for your care.
• Payment: Disclosing information for processing insurance claims or obtaining
• Healthcare Operations: Use for internal administration, case management, or quality assessment.
• Insurance Functions: Performing specific functions regulated by the Texas Insurance Code.
• Legal Requirements: As authorized or required by state or federal law.