Pasadena Clinical GroupSocial Anxiety Program

Notice of Privacy Practices

How your health information may be used and disclosed, and your rights under HIPAA and California law.

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.

Template content. This Notice must be reviewed and finalized by the practice's California-licensed healthcare attorney and HIPAA Privacy Officer before publication.

Effective date: April 29, 2026 · Last updated: April 29, 2026 · Privacy Officer: office@pasadenaclinicalgroup.com

1. Our pledge regarding your health information.

Pasadena Clinical Group ("PCG") is required by federal law (the Health Insurance Portability and Accountability Act, "HIPAA") and California law (the Confidentiality of Medical Information Act, "CMIA", Civil Code §56 et seq., and Welf. & Inst. Code §5328 for mental-health records) to maintain the privacy of your protected health information ("PHI"), provide you with this Notice of our legal duties and privacy practices, abide by the terms of the Notice currently in effect, and notify you in the event of a breach of unsecured PHI.

2. California is stricter than HIPAA.

Where California law provides greater protection than HIPAA, the stricter California provision applies. CMIA requires written authorization for many uses and disclosures that HIPAA would otherwise permit; California's mental-health-records statute (Welf. & Inst. Code §5328) provides additional protection for psychotherapy records.

3. How we may use and disclose your PHI.

For treatment.

We may use and disclose PHI to provide your care and to coordinate care with other providers (for example, your primary-care physician or psychiatrist). When CMIA authorization is required, we will obtain it.

For payment.

We may use and disclose PHI to bill and collect payment for services from you, your insurer, or another responsible party. This may include providing diagnosis, dates of service, and treatment plans to your insurer for authorization.

For health care operations.

We may use and disclose PHI for activities necessary to operate the practice, including quality improvement, training, and audits. Where CMIA requires authorization for these uses, we will obtain it.

Without your authorization, we may also disclose PHI:

  • As required by law, including reporting child abuse and neglect (CANRA, Penal Code §11164 et seq.), elder/dependent adult abuse (Welf. & Inst. Code §15630), and gunshot wounds.
  • For Tarasoff duty to warn or protect (Civil Code §43.92).
  • For public health activities and to prevent serious threats to health or safety.
  • For health oversight, judicial proceedings, law enforcement, coroners and medical examiners, organ donation, research with an IRB-approved waiver, military and veterans, workers' compensation, or as authorized by law.
  • To business associates who provide services on our behalf, under contracts that require them to safeguard your PHI.

4. Uses and disclosures that require your written authorization.

The following uses and disclosures require your specific written authorization, which you may revoke at any time in writing:

  • Most uses and disclosures of psychotherapy notes (the clinician's separate process notes).
  • Uses and disclosures for marketing.
  • Sales of PHI.
  • Most disclosures to family members or others not directly involved in your care.
  • Other uses and disclosures not described in this Notice.

5. Your rights.

  • Right to inspect and copy. You may inspect and copy your PHI, including your clinical record. Under California Health & Safety Code §123100 et seq., we will allow inspection within 5 business days and copies within 15 calendar days of a written request. We may charge a reasonable cost-based fee for copies.
  • Right to amend. You may request that we amend PHI you believe is inaccurate or incomplete.
  • Right to an accounting of disclosures. You may request a list of certain disclosures of your PHI.
  • Right to request restrictions. You may request that we restrict certain uses and disclosures. We are not required to agree, except for disclosures to a health plan for payment or healthcare operations when you have paid in full out of pocket.
  • Right to confidential communications. You may request that we communicate with you by alternative means or at alternative locations.
  • Right to a paper copy of this Notice. You may request one at any time.
  • Right to be notified of a breach. We will notify you if there is a breach of your unsecured PHI.
  • Right to file a complaint. You may complain to us or to the U.S. Secretary of Health and Human Services if you believe your privacy rights have been violated. We will not retaliate against you for filing a complaint.

6. Changes to this Notice.

We may change the terms of this Notice and apply the new terms to all PHI we maintain. Changes will be posted in the office and on this Site, and a copy of the current Notice will be provided to you on request.

7. Contact our Privacy Officer.

If you have questions about this Notice or wish to exercise any of your rights, contact our Privacy Officer at office@pasadenaclinicalgroup.com or (626) 354-6440.

8. To file a complaint.

You may also file a complaint with the U.S. Secretary of Health and Human Services, Office for Civil Rights:

200 Independence Avenue, S.W.
Washington, D.C. 20201
Toll-free: 1-877-696-6775
https://www.hhs.gov/ocr/complaints/index.html