HIPAA Notice of Privacy Practices

Effective Date: January 1, 2026
Last Updated: April 2026

Notice of Privacy Practices

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.

Our Commitment to Your Privacy

Pasadena Clinical Group is required by law to maintain the privacy of your Protected Health Information (PHI), provide you with this Notice of our legal duties and privacy practices, and abide by the terms of the Notice currently in effect. We are required to notify you if a breach of your unsecured PHI occurs.

How We May Use and Disclose Your Health Information

For Treatment

We may use or disclose your PHI to provide, coordinate, or manage your treatment and related services. This includes coordination or management of your care with a third party. For example, we may share information with another therapist providing individual therapy if you have provided written authorization.

For Payment

We may use and disclose your PHI to obtain payment for services we provide to you. This includes billing and collection activities, and related data processing. For example, we may send your PHI to your health insurance plan to obtain payment for therapy services.

For Health Care Operations

We may use or disclose your PHI for activities necessary to operate our practice, including quality assessment, staff training, licensing, and accreditation activities.

Other Permitted Uses and Disclosures

We may use or disclose your PHI without your authorization in the following circumstances as required or permitted by law:

• When required by federal, state, or local law
• For public health activities (e.g., reporting communicable diseases)
• When there is a reasonable belief that disclosure is necessary to prevent serious and imminent threat to a person or the public
• For health oversight activities
• In response to a court order or administrative tribunal
• For law enforcement purposes as required by law
• To avert a serious threat to health or safety
• For specialized government functions (e.g., military, national security)
• As required for workers' compensation proceedings

Uses and Disclosures Requiring Your Authorization

We will obtain your written authorization before using or disclosing your PHI for purposes other than those described above, including:

• Psychotherapy notes (if applicable)
• Marketing purposes
• Sale of your PHI

You may revoke any authorization at any time by submitting a written request to our office.

Your Rights Regarding Your Health Information

• Right to Access: You have the right to inspect and obtain a copy of your PHI maintained by us.
• Right to Amend: You may request that we amend your PHI if you believe it is incorrect or incomplete.
• Right to an Accounting of Disclosures: You may request a list of disclosures of your PHI that we have made.
• Right to Request Restrictions: You may request restrictions on how we use or disclose your PHI for treatment, payment, or health care operations.
• Right to Request Confidential Communications: You may request that we communicate with you in a specific way or at a specific location.
• Right to a Paper Copy of This Notice: You may request a paper copy of this notice at any time.

Complaints

If you believe your privacy rights have been violated, you may file a complaint with our practice or with the Secretary of the U.S. Department of Health and Human Services. You will not be retaliated against for filing a complaint.

Contact Information

Pasadena Clinical Group
301 N. Lake Ave, STE 600
Pasadena, CA 91101
Phone: 626-354-6440
Fax: 323-801-8264