Telehealth Agreement
1. Definition and scope
Telehealth, as defined under California Business & Professions Code §2290.5, means the mode of delivering health-care services and public-health activities via information and communication technologies to facilitate the diagnosis, consultation, treatment, education, care management, and self-management of a patient's health care while the patient is at the originating site and the health-care provider is at a distant site. Telehealth includes synchronous interactions and asynchronous store-and-forward transfers.
2. Informed consent
California requires that, prior to the delivery of telehealth services, the health-care provider obtain verbal or written consent from the patient. This Telehealth Agreement, together with verbal confirmation in your first telehealth session, satisfies that requirement. You may withdraw your consent to telehealth at any time, in which case in-person sessions will be offered subject to availability.
3. Anticipated benefits
- Improved access to care (no commute, easier scheduling around work and family).
- Reduced barriers for clients with mobility, transportation, or geographic constraints.
- Ability to maintain continuity of care during illness, travel, or temporary relocation within California.
- Same clinical standards as in-person sessions.
4. Anticipated risks and limitations
- Telehealth depends on technology — connections may drop, audio or video quality may be impaired, and software updates may interrupt sessions.
- Some clinical interventions, particularly those requiring close in-person observation, are not appropriate for telehealth.
- Privacy considerations differ — you must take reasonable steps to ensure your end of the connection is private and secure.
- In the event of a clinical emergency during a telehealth session, your clinician may need to contact emergency services in your physical location; you will be asked at the start of each telehealth session to confirm your current location and an emergency contact.
5. Patient location and California licensure
Pasadena Clinical Group's clinicians are licensed in California. You must be physically located in California at the time of any telehealth session. If you are temporarily outside California, please notify us in advance — we may need to defer the session, briefly accommodate per the relevant state's interjurisdictional rules where applicable, or arrange a referral to a clinician licensed in your current jurisdiction.
6. Technology and security
We use HIPAA-compliant videoconferencing platforms with end-to-end encryption. We will not record sessions. You agree not to record any portion of any session, audio or video, without the prior written consent of your clinician. Unauthorized recording may be a violation of California Penal Code §632 (eavesdropping on confidential communications) and may result in termination of services and other legal consequences.
7. Privacy on your end
You are responsible for choosing a private, secure location for telehealth sessions. We recommend a quiet room with a closed door, headphones, and a stable internet connection. Public Wi-Fi (cafés, airports, hotels) is not appropriate for telehealth sessions.
8. Emergency procedure
Telehealth is not appropriate for emergencies. If you are in imminent danger of harming yourself or someone else, do not attempt to handle it through a telehealth session — call 911, go to the nearest emergency room, or call or text 988 (the Suicide & Crisis Lifeline). At the start of each telehealth session, you will confirm your current physical address and an emergency contact name and phone number, in case your clinician needs to reach emergency services on your behalf.
9. Confidentiality and records
Telehealth sessions are subject to the same confidentiality protections as in-person sessions, including HIPAA, CMIA, and California psychotherapist-patient privilege, with the same mandatory exceptions described in our Treatment Consent. Telehealth notes are stored in our HIPAA-compliant electronic health record.
10. Availability
Telehealth is available seven (7) days a week subject to clinician availability. Standard scheduling, cancellation, and lateness policies apply (see Office Policies).
11. Acknowledgment
By proceeding with a telehealth session, you confirm that you have read this Agreement, have had an opportunity to ask questions, and consent to receiving care via telehealth. You acknowledge that you may revoke consent for telehealth at any time.
12. Contact
Pasadena Clinical Group · 301 N. Lake Ave, STE 600, Pasadena, CA 91101 · (626) 354-6440 · office@pasadenaclinicalgroup.com