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Include the following notice if a minor is named in the style of the case or if the subpoena contains other unredacted sensitive data. See § 6 of the Introduction in volume 1 of this manual concerning protection of sensitive data in filed documents. |
NOTICE: THIS DOCUMENT
CONTAINS SENSITIVE DATA
Subpoena to Compel Production of Protected Health Information of [name of patient]
Issued in the Name of the State of Texas
You, [name of witness], are hereby commanded to appear at [address, city, county], Texas, on [date] at [time] and produce at that time and place the following documents or tangible things in your possession, custody, or control relating to the case entitled “[style of case]” and filed under Cause No. [number], in the [designation] Court of [county] County, Texas: [specify].
This subpoena is based on a qualified protective court order issued by the [designation] Court of [county] County, Texas. A certified copy of the qualified protective order is attached to this subpoena. This subpoena is issued at the instance of [name of party], [Petitioner/Respondent/Intervenor] in the above-referenced case [include if applicable: , by and through [his/her/its] attorney of record, [name of attorney]].
Failure of any person without adequate excuse to obey a subpoena served on that person may be deemed a contempt of the court from which the subpoena is issued or a district court in the county in which the subpoena is served, and may be punished by fine or confinement, or both.
This subpoena is issued on [date] by:
[Name of person issuing subpoena]
[Capacity]
[Address]
[Telephone]
[Fax]
Proof of Service
I, [name of witness], accept service of the attached subpoena and will appear at the time and place directed in the subpoena.
Date: ___________________________________.
(Signature of witness)
I, ___________________________________, am over the age of eighteen years. I am not a party in the above-entitled and -numbered cause of action. On ______________ I served a subpoena, of which this is a true and correct copy, on [name of witness] by personally handing the subpoena to the named individual or in accordance with rule 176.5(a) of the Texas Rules of Civil Procedure. I also tendered to the witness the witness fees required by law at the time the subpoena was delivered.
Date: ___________________________________.
(Signature of person serving subpoena)
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Attach copy of qualified protective order. See form 5-34. |