THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
1. Our Pledge Regarding Your Health Information
Pasadena Clinical Group ("PCG," "we," "us," or "our") is committed to maintaining the privacy of your Protected Health Information ("PHI"). PHI includes any information about you, including demographic information, that may identify you and that relates to your past, present, or future physical or mental health condition and related health-care services. We are required by federal law (the Health Insurance Portability and Accountability Act, or "HIPAA") and California law (the Confidentiality of Medical Information Act, or "CMIA," and the Lanterman-Petris-Short Act, where applicable) to (a) maintain the privacy of your PHI; (b) provide you with this Notice describing our legal duties and privacy practices regarding PHI; (c) notify you in the event of a breach of unsecured PHI; and (d) follow the terms of the Notice currently in effect.
2. Effective Date and Scope
This Notice is effective as of April 28, 2026 and applies to all PHI created or received by Pasadena Clinical Group, our workforce members, our supervised trainees, our business associates, and any covered entity acting on our behalf.
3. Permitted Uses and Disclosures Without Your Authorization
We may use and disclose your PHI for the following purposes without your specific written authorization, except where heightened protections apply (described in Section 5).
(a) Treatment
We may use and disclose PHI to provide, coordinate, or manage your psychological care. For example, we may share information with another provider whom you have asked us to coordinate with (such as your primary care physician, OB-GYN, psychiatrist, or other treating clinician). Within Pasadena Clinical Group, your treatment team and supervisors may use your information to coordinate your care.
(b) Payment
We may use and disclose PHI for payment purposes, including billing, collection, claim submission, eligibility determinations, and medical-necessity reviews by your insurance carrier or other payor.
(c) Health Care Operations
We may use and disclose PHI for our health-care operations, including quality assessment, clinician credentialing, supervision of practicum and internship trainees, training and accreditation activities, audits, legal and compliance functions, and general administrative activities.
(d) Required by Law
We may use and disclose PHI when required by applicable federal, state, or local law, including but not limited to:
- Mandated reporting of suspected abuse, neglect, or exploitation of a child, dependent adult, or elder under California law (Cal. Penal Code §§ 11164 et seq. and Cal. Welf. & Inst. Code §§ 15600 et seq.)
- Reporting of communicable diseases and other public-health activities
- Disclosures required by valid court orders, subpoenas, or other lawful process
- Disclosures required by professional-licensing or oversight authorities
(e) To Avert Serious Threat to Health or Safety
Consistent with applicable law and ethical standards, we may use or disclose PHI when necessary to prevent or lessen a serious and imminent threat to the health or safety of you or another identifiable person, or to the public — and only to a person reasonably able to prevent or lessen the threat. This includes "Tarasoff" and "Ewing" duties under California law.
(f) Public Health Activities
We may disclose PHI for public-health activities, including reporting to authorities authorized to receive such reports, reporting product defects, and notifying persons who may have been exposed to a communicable disease.
(g) Health Oversight Activities
We may disclose PHI to a health-oversight agency for activities authorized by law, such as audits, investigations, inspections, and licensure actions.
(h) Judicial and Administrative Proceedings
We may disclose PHI in response to a court order, subpoena, discovery request, or other lawful process, generally only after we have made reasonable efforts to (i) notify you of the request or (ii) obtain a qualified protective order.
(i) Law Enforcement Purposes
In limited circumstances we may disclose PHI to law enforcement officials in response to a court order, warrant, grand-jury subpoena, or other lawful request, or where disclosure is otherwise specifically permitted by law.
(j) Coroners, Medical Examiners, and Funeral Directors
We may disclose PHI to a coroner, medical examiner, or funeral director as authorized by law.
(k) Workers' Compensation
We may disclose PHI as authorized by, and to the extent necessary to comply with, laws relating to workers' compensation or other similar programs.
(l) Specialized Government Functions
We may use or disclose PHI for activities such as military and veterans' affairs, national security and intelligence, protective services for the President and others, medical suitability determinations, correctional institutions, and government-program eligibility determinations, all to the extent permitted by law.
(m) Research
We may use or disclose PHI for research purposes only with your written authorization or with appropriate Institutional Review Board (IRB) approval and documented waiver of authorization.
4. Uses and Disclosures Requiring Your Written Authorization
Except as otherwise described in this Notice, we will obtain your written authorization before using or disclosing your PHI. In particular, the following uses and disclosures will be made only with your specific written authorization:
- Most uses and disclosures of psychotherapy notes (notes the therapist may keep separate from the formal record), with limited exceptions for treatment, supervision, and certain mandated reporting
- Uses and disclosures for marketing purposes (other than face-to-face communications and certain promotional gifts of nominal value)
- Disclosures that constitute a sale of PHI
- Other uses and disclosures not described in this Notice
You may revoke a previously given authorization at any time by submitting a written revocation to our Privacy Officer. Revocation will not affect uses or disclosures already made in reliance on your authorization.
5. Heightened Protections Under California Law
California law provides additional confidentiality protections for certain categories of information, and we follow those heightened standards:
- Mental health information generally requires specific written authorization for disclosure beyond treatment, payment, and operations.
- Substance use disorder information may be subject to 42 CFR Part 2, which provides additional protections beyond HIPAA.
- HIV/AIDS-related information is subject to the California Health and Safety Code § 120975, which restricts disclosure.
- Reproductive health information and gender-affirming care information may be subject to additional California protections, including Cal. Civ. Code §§ 56.108 and 56.109, restricting disclosures sought from out-of-state authorities.
- Genetic information is subject to additional restrictions under the federal Genetic Information Nondiscrimination Act (GINA) and California's CalGINA.
6. Telehealth Services
If you receive services via secure telehealth, your PHI is protected with the same standards as in-person care. We use HIPAA-aware video and messaging platforms with Business Associate Agreements in place. You are responsible for choosing a private physical environment for your sessions and for protecting your own device and login credentials.
7. Group Therapy
If you participate in group therapy, the clinician will protect your PHI in accordance with this Notice. However, we cannot guarantee that other group members will keep what is shared confidential. Group rules and confidentiality expectations are reviewed at the start of any group, and members are expected to honor those expectations.
8. Trainees and Supervision
Pasadena Clinical Group is a training site that may host doctoral-level psychology trainees on practicum, externship, or pre-doctoral internship. Trainees and supervisors may have access to your PHI for purposes of treatment, consultation, and supervision. If your treating clinician is a trainee, you will be informed of their role and the licensed clinician supervising them, and you have the right to decline to be seen by a trainee.
9. Family, Friends, and Others Involved in Your Care
With your verbal agreement (or, where appropriate, your reasonable inferred consent), we may share PHI relevant to a family member, friend, or other person you have identified as involved in your care or payment for your care. We will use professional judgment in determining whether the disclosure is in your best interest if you are unable to express agreement (e.g., due to incapacity or emergency).
10. Minors
California law provides minors of certain ages with the right to consent to specific health-care services without parental involvement (e.g., Cal. Family Code § 6924 for outpatient mental-health services for minors aged 12 and older who meet specific criteria). When a minor consents to their own care, we generally do not disclose treatment information to a parent or legal guardian without the minor's authorization, except as required by law.
11. Your Individual Rights Regarding PHI
(a) Right to Inspect and Copy
You have the right to inspect and obtain a copy of PHI maintained in your designated record set, with limited legal exceptions. We may charge a reasonable, cost-based fee. Requests must be in writing.
(b) Right to Request Amendment
You have the right to request that we amend PHI we maintain about you if you believe it is incorrect or incomplete. We may deny requests under certain circumstances permitted by law.
(c) Right to an Accounting of Disclosures
You have the right to receive an accounting of certain disclosures of your PHI made by us within the six (6) years prior to the date of your request, excluding disclosures for treatment, payment, health-care operations, disclosures made to you, and certain other categories.
(d) Right to Request Restrictions
You have the right to request restrictions on certain uses and disclosures of your PHI for treatment, payment, or health-care operations. We are not required to agree to most requests, but we will agree to a request to restrict disclosure to a health plan when (i) the disclosure is for purposes of payment or health-care operations and not otherwise required by law, and (ii) the PHI pertains solely to a health-care item or service for which you have paid out of pocket in full.
(e) Right to Confidential Communications
You have the right to request that we communicate with you about medical matters in a certain way or at a certain location (e.g., only at your work address, only by telephone, or only at a specific email).
(f) Right to a Paper Copy of This Notice
You have the right to a paper copy of this Notice on request, even if you have agreed to receive it electronically.
(g) Right to Be Notified of a Breach
You have the right to be notified in the event of a breach of your unsecured PHI.
(h) Right to Revoke an Authorization
You have the right to revoke any authorization you have provided, in writing, except to the extent we have already taken action in reliance on it.
12. Our Duties
We are required by law to maintain the privacy of PHI, to provide you with this Notice of our legal duties and privacy practices with respect to PHI, to notify affected individuals following a breach of unsecured PHI, and to abide by the terms of the Notice currently in effect. We reserve the right to change the terms of this Notice at any time and to make the new Notice provisions effective for all PHI we maintain. The current Notice will be posted at our office and at www.pasadenaclinicalgroup.com/hipaa-notice.html.
13. Complaints
You may file a complaint if you believe we have violated your privacy rights. Complaints may be filed with our Privacy Officer or with the U.S. Department of Health and Human Services (HHS) Office for Civil Rights. We will not retaliate against you for filing a complaint.
HHS Office for Civil Rights
200 Independence Avenue, SW — Washington, DC 20201
Toll-free: 1-877-696-6775
www.hhs.gov/ocr/
14. Contact Information — Privacy Officer
Privacy Officer
Pasadena Clinical Group
301 N. Lake Ave, STE 600
Pasadena, CA 91101
Phone: 626-354-6440
Email: office@pasadenaclinicalgroup.com