Telehealth Informed Consent & Agreement

What telehealth is

Telehealth is the delivery of clinical health care services using interactive audio, video, or data communications technology, where the patient and clinician are in different physical locations. At Pasadena Clinical Group, telehealth is used for outpatient psychotherapy — including individual therapy and, where clinically appropriate, group therapy.

Telehealth is not a different kind of therapy. It is the same evidence-informed, perinatal-focused care our clinicians provide in person, delivered through a secure remote channel.

Scope of telehealth at our practice

Telehealth is offered seven days a week between 7:00 AM and 9:00 PM Pacific Time, subject to clinician availability. Telehealth may be appropriate for routine therapy sessions, intake conversations with our care coordinator, certain group therapy modalities, and follow-up care. It is not appropriate for psychiatric emergencies, in-person assessments that require direct observation, or court-ordered evaluations that require in-person attendance.

California legal framework: Bus. & Prof. Code §2290.5

California Business and Professions Code §2290.5 governs the delivery of telehealth services in California. Under that section:

• Your clinician will obtain your verbal or written consent for the use of telehealth before the first telehealth encounter.
• Telehealth may include synchronous (real-time) video or audio interaction, and asynchronous transmissions where clinically appropriate.
• Your clinician must hold an active, unrestricted California license at the time of each telehealth session.
• You retain all the rights you would have in an in-person session, including the right to ask questions, the right to refuse telehealth, and the right to withdraw consent at any time.

Technology and platform

We deliver telehealth through a HIPAA-compliant video platform that uses end-to-end encryption and is configured under a Business Associate Agreement (BAA) with the platform provider. You will receive a secure session link before each appointment.

Minimum technical requirements on your end:

• A reliable broadband internet connection (recommended: 5 Mbps up/down or better).
• A device with a working camera and microphone (laptop, desktop, tablet, or smartphone).
• An up-to-date browser (Chrome, Safari, Firefox, or Edge), or the platform's mobile app.
• A private, quiet location where you will not be overheard or interrupted.

If technology fails during a session, your clinician will attempt to reconnect. If reconnection is not possible, the session may be completed by phone, rescheduled, or converted to an in-person appointment as appropriate.

Privacy and security

We follow HIPAA and the California Medical Information Act (CMIA, Civ. Code §56 et seq.) in delivering telehealth services. The video platform we use is configured to encrypt audio and video, and we use authentication controls to prevent unauthorized access to sessions. We do not record telehealth sessions absent your written consent.

You are responsible for the privacy of your end of the session — for example, by attending from a private space, using a private device, and not allowing other people to listen to or watch the session without disclosure to your clinician. Your clinician is responsible for the privacy of their end of the session.

Patient location requirement

You must be physically located in the State of California at the time of each telehealth session. Our clinicians are licensed in California and are not authorized to provide therapy across state lines into jurisdictions where they do not hold a license. If you will be traveling outside California, please notify your clinician in advance so we can determine whether the session can proceed, must be rescheduled, or requires conversion to an in-person session.

Availability and scheduling

Telehealth sessions are scheduled the same way as in-person sessions, through our front office or your clinician's portal. Telehealth is available seven days a week within our published hours. Cancellation and lateness policies are the same for telehealth as for in-person sessions — see Office Policies.

Limitations and risks of telehealth

• Some clinical concerns are better addressed in person. Your clinician will recommend in-person care if telehealth is not the right fit.
• Non-verbal information that supports clinical assessment (posture, breath, affect cues) may be harder to read on video.
• Technology can fail — calls drop, video freezes, audio degrades. We have backup procedures, but interruptions are part of the medium.
• Privacy depends partly on your environment. Headphones and a private room reduce the risk that others overhear sensitive material.
• Despite encryption and BAAs, no electronic communication is fully impervious to interception by determined attackers. The risk is low but not zero.

Emergencies and crisis

At the start of telehealth care, your clinician will collect an emergency contact and confirm the address you typically attend sessions from, in case emergency services need to be dispatched on your behalf during a session.

Recording and confidentiality

Telehealth sessions are confidential and are governed by the same standards as in-person sessions, including HIPAA, CMIA, and the limits of confidentiality described in our Consent to Treatment. Recording of any kind by either party is prohibited absent written, mutual consent. Screen-recording, audio-recording, or screenshotting telehealth sessions without consent may constitute a violation of California privacy law.

Your rights

• Right to refuse telehealth. You may decline telehealth at any time and request in-person care, subject to scheduling and clinical appropriateness.
• Right to withdraw consent. You may withdraw consent to telehealth at any time, in writing or verbally, without prejudice to your ongoing care.
• Right to information. You have the right to ask questions about the telehealth platform, encryption, your data, and the credentials of your clinician.
• Right to records. Your telehealth records are part of your clinical record and are governed by California Health & Safety Code §123100 et seq.
• Right to alternative care. If telehealth is not appropriate for your situation, you have the right to a referral to an in-person clinician or higher level of care.

Fees and insurance

Telehealth sessions are billed at the same rate as comparable in-person sessions. Most California health plans cover telehealth at parity with in-person care under the California Telehealth Advancement Act (AB 744). Coverage details vary by plan; our care coordinator will verify benefits before your first session. See Insurance & Coverage.

Informed consent

By scheduling and attending a telehealth session at Pasadena Clinical Group, you confirm that:

• You have read this Telehealth Agreement and the related Consent to Treatment, Notice of Privacy Practices, and Privacy Policy.
• You have had the opportunity to ask questions about telehealth and have received answers to those questions.
• You consent to receive psychotherapy services by telehealth, understanding the limitations and risks described above.
• You will be physically located in California at the time of each telehealth session.
• You may withdraw this consent at any time, in writing or verbally, without affecting your right to continued care.

If you have questions or concerns about this Telehealth Agreement, please contact our office at 626-354-6440 or office@pasadenaclinicalgroup.com before your next session.

Application to all Released Parties

Every protective provision of this Telehealth Agreement — including provisions regarding scope, technology, privacy and security, location, limitations and risks, recording, and rights — applies for the benefit of, and may be enforced by, each and every "Released Party" as defined in Terms & Conditions Section 2. The Released Parties include, without limitation, Pasadena Clinical Group; its parent, subsidiary, and affiliated entities; its directors, officers, members, owners, and shareholders; all employees, clinicians, supervisors, supervisees, trainees, and interns; the telehealth-platform provider and any subcontractors of the platform; all other independent contractors, consultants, agents, vendors, and business associates engaged in delivering or supporting telehealth services; and the heirs, representatives, successors, and assigns of any of the foregoing. Each Released Party is an intended third-party beneficiary of this Agreement and may enforce it directly.

Dispute resolution and limitation of liability

Any dispute arising out of or relating to telehealth services is subject to the stepped dispute-resolution process — informal resolution, mandatory pre-suit mediation, binding individual arbitration, class-action waiver, and jury-trial waiver — set out in our Office Policies and Terms & Conditions Section 11, except for matters that, under California law, may not be subject to mandatory arbitration absent a separate Code of Civil Procedure §1295-compliant signed agreement, and except for emergency injunctive relief. Limitation of liability for non-malpractice claims arising out of telehealth services is governed by Terms & Conditions Section 9; indemnification is governed by Section 10. Nothing in this Telehealth Agreement waives or limits any non-waivable rights or remedies you have under California professional-licensing law, HIPAA, CMIA, or other applicable law.