In accordance with House Bill 4224 and Texas Health and Safety Code Section 181.105, Nicole Everett, MA, LPC-S, LMFT-S provides the following information to assist clients and members of the public with:

• Requesting access to health care records

• Contacting the state licensing authority

• Filing a consumer complaint

How to Request Your Health Care Records:

Current and former clients may request copies of their counseling and mental health records. Requests may

Requests may be submitted using one of the following methods: Email Nicole Everett at nicole@neverettlmft.com or call at 972-533-5775. To help prevent delays, please include the following information with your request:

• Client full legal name and date of birth

• Current phone number and or email address

• Description of records requested including specific dates if applicable

• Preferred method of delivery such as secure electronic delivery, mail, or in person pickup

• Client signature and date

If records are requested on behalf of another individual, documentation verifying legal authority is required. Examples include guardianship documentation or medical power of attorney. Identity verification may be required to protect client privacy and confidentiality in accordance with applicable state and federal laws.

Licensing Authority Information

Nicole Everett, MA, LPC-S, LMFT-S is regulated by the Texas Behavioral Health Executive Council, the licensing authority for Licensed Professional Counselors, Licensed Marriage and Family Therapists and Licensed Clinical Social Workers in the State of Texas. Questions regarding licensure or professional regulation may be submitted through the Council’s website:

https://bhec.texas.gov/contact-us/

When submitting an inquiry, select the specific license as the license type.

Filing a Consumer Complaint

Clients or members of the public who wish to file a consumer complaint may do so through the Texas Office of the Attorney General Consumer Protection Division.

Complaints may be submitted online at:

https://www.texasattorneygeneral.gov/consumer-protection/file-consumer-complaint

When submitting a complaint, include relevant dates, names, and any supporting documentation if available.