How to Request Mental Health Records
To obtain your records, please follow the steps below.
Submit a written request
Email your written request to: amanda@amandanorcross.com.
Use the subject line, “Request for Records”.
Include the following:
A completed Authorization form that indicates the specific records you are requesting (for example, "all records from January 2024 to present" or "entire record"). I can provide you with this form to complete
Whether you want electronic or paper records
Records fee
Fee for providing electronic records: $25
Fee for providing paper records: $0.50 per page for the first 25 pages; $0.25 per page thereafter
Actual cost of postage/shipping, if applicable
Accepted payment methods: credit card
Arkansas and Texas law do not require records to be released until fees are paid.
Additional requirements (if applicable)
Litigation-Related Records
If records are requested for use in litigation, please include:
Case number
Case title
Court where the case is pending
Business Records Affidavit
If you require a Business Records Affidavit, indicate this in your request.
Fee: $15
Affidavits will not be provided until payment is received.
Couples, Family, or Third-Party Records
If you are requesting couples counseling records, family counseling records, or records for anyone other than yourself or your child, state and federal law require either:
A valid Court Order or
An Authorization signed by the individual (or parent/legal guardian)
Relevant law: 45 C.F.R. §164.512(e); Arkansas Code §§16-46-106, 17-27-416; Texas Health & Safety Code §§611.004, 611.0045, 611.008
Instructions for Attorneys and Document Companies
A subpoena alone is not sufficient to compel disclosure of confidential counseling or billing records, or other Protected Health Information (PHI), under HIPAA (45 C.F.R. Chapter 164).
For mental health or medical records requested or subpoenaed in litigation (including testimony), HIPAA permits disclosure only under the following circumstances:
In response to a valid court or administrative tribunal order, or
When the individual (or parent/legal guardian):
Is a party to the proceeding
Has notice that the PHI has been requested
Does not object to the disclosure
An Authorization from the individual or parent satisfies this requirement.
Relevant law: 45 C.F.R. §164.512(e)
Note: If the client or parent has indicated that they do not consent to release of records:
A “Statement of Assurance” will not be accepted.
A valid Authorization or Court Order will be required.