1. (a) Request for chiropractic records. Upon request, a licensee shall furnish copies of chiropractic records or a summary or narrative of the records pursuant to a written consent for the release of the information or records. The requested information or record shall not be released if the licensee determines that access to the information would be harmful to the physical, mental, or emotional health of the patient. The licensee may delete from the requested records confidential information about another person who has not consented to release. For purposes of this chapter, "chiropractic records" means any records pertaining to the history, diagnosis, treatment or prognosis of the patient including records of other health care practitioners contained in the records of the licensee to whom a request for release of records has been made. "Patient" means any person who consults or is seen by a licensee for the purposes of receiving chiropractic care.

2. (b) Written consent.

   1. (1) The written consent required by subsection (a) of this section shall be signed by:

      1. (A) the patient;
      2. (B) the patients' personal representative if the patient is deceased;
      3. (C) a parent or legal guardian if the patient is a minor;
      4. (D) a legal guardian if the patient has been adjudicated incompetent to manage his or her personal affairs; or
      5. (E) an attorney ad litem for the patient as authorized by law, including the Health and Safety Code, Title 7, Family Code, Chapter 11 or the Probate Code, Chapter 5.
   2. (2) The written consent shall contain the specific information or chiropractic records to be released under the consent; the reasons or purposes for the release; and the person to whom the information is to be released.
   3. (3) The patient, or other person authorized to consent, has the right to withdraw the consent to the release of any information. Withdrawal of consent does not affect any information disclosed prior to the written notice of the withdrawal. Any person who received information made confidential by the Chiropractic Act may disclose the information to others only to the extent consistent with the authorized purposes for which consent to release information was obtained.
3. (c) Reasonable time. A copy of chiropractic records or a summary or narrative of the records requested under subsection (a) of this section shall be furnished by the licensee within reasonable time after the date of the request.
4. (d) Denial of request. If the licensee denies the request under subsection (a) of this section for a copy of chiropractic records or a summary or narrative of the records, either in whole or in part, the licensee shall furnish the patient a written statement, signed and dated, stating the reason for the denial. Chiropractic records requested pursuant to subsection (a) of this section may not be withheld based on a past due account for care or treatment previously rendered to the patient.

5. (e) Fee for records. The licensee may charge a reasonable fee for furnishing the information requested under subsection (a) of this section, in accordance with the following provisions:

   1. (1) The fee shall be paid by the patient or someone else on the patient's behalf.
   2. (2) A licensee may require payment in advance except from another licensee or other health care provider, including a chiropractor licensed by any other state, territory, or insular possession of the United States or any state or province of Canada, if requested for purposes of emergency or acute medical care.
   3. (3) In the event payment is not received, within ten calendar days from notification of the charge, the licensee shall notify the requesting party in writing of the need for payment.

   4. (4) A reasonable fee for a paper copy shall be a charge not to exceed:

      1. (A) $30 for retrieval of records and processing the request, including copies for the first 10 pages;
      2. (B) $1.00 per page for pages 11-60;
      3. (C) $.50 per page for pages 61-400; and
      4. (D) $.25 per page for pages over 400;
   5. (5) A reasonable fee for copies of films or other static diagnostic imaging studies shall be a charge not to exceed $45 for retrieval and processing, including copies for the first 10 pages, and $1.00 for each additional page over 10.
   6. (6) Reasonable fees may also include actual costs for mailing, shipping or delivery.
6. (f) Subpoena not required. A subpoena shall not be required for the release of chiropractic records requested pursuant to subsection (a) of this section.
7. (g) Renewal of licenses. A licensee shall furnish a written explanation of his or her answer to any question asked on the application for license renewal, if requested by the board. This explanation shall include all details as the board may request and shall be furnished within two weeks of the date of the board's request.

8. (h) Impaired licensees.

   1. (1) The board shall require a licensee to submit to a mental and/or physical examination by the appropriate health care provider designated by the board if the board has probable cause to believe that the licensee is impaired. An impaired licensee is considered to be one who is unable to practice chiropractic with reasonable skill and safety to patients by reason of age, illness, drunkenness, excessive use of drugs, narcotics, chemicals, or any other type of material; or as a result of any mental or physical condition.

   2. (2) Probable cause may include, but is not limited to, any one of the following listed in subparagraphs (A)-(F) of this paragraph:

      1. (A) sworn statements from two people, willing to testify before the board, that a certain licensee is impaired;
      2. (B) evidence that a licensee left a treatment program for alcohol or chemical dependency before completion of that program;
      3. (C) evidence that a licensee is guilty of intemperate use of drugs or alcohol;
      4. (D) evidence of repeated arrests of a licensee for intoxication;
      5. (E) evidence of recurring temporary commitments to a mental institution of a licensee; or
      6. (F) chiropractic records showing that licensee has an illness or condition which results in the inability to function properly in his or her practice.

Source Note:The provisions of this §80.3 adopted to be effective June 15, 2000, 25 TexReg 5628; amended to be effective February 7, 2001, 26 TexReg 1141; amended to be effective June 3, 2001, 26 TexReg 3746.