Patient Rights & Notices

Psychological Healing, Inc. is committed to protecting your privacy and to being clear about the cost of your care. This page contains our Notice of Privacy Practices and information about your right to receive a Good Faith Estimate.

• Notice of Privacy Practices
• Your Right to a Good Faith Estimate
• Questions

Notice of Privacy Practices

Download the Notice of Privacy Practices (PDF)

You can also ask us for a paper copy at any time.

Psychological Healing, Inc.

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.

Effective date: October 17, 2026

Questions about this notice or your privacy rights? Contact our Privacy Officer: Karan Singh, PhD, Founder & Privacy Officer. Email: admin@psychologicalhealing.net. Phone: 949-229-5820.

Mailing address (mail only; not a walk-in office): Psychological Healing, Inc., 20101 SW Birch Street, Suite #240, Newport Beach, CA 92660. Website: https://psychologicalhealing.net/patient-rights-notices/

This notice applies to Psychological Healing, Inc. (National Provider Identifier 1760218754), a California-incorporated psychology group practice, and to all clinicians (including independent-contractor clinicians), trainees, and staff when they provide services through Psychological Healing, Inc., in person at our office locations in multiple states or by telehealth. It does not apply to services a clinician provides outside our practice.

Your Information. Your Rights. Our Responsibilities.

We understand that information about you and your mental health care is personal and sensitive. We are committed to protecting it. This notice explains how we may use and share your health information, your rights, and our legal duties. In this notice, "health information" means protected health information (PHI): information that identifies you and relates to your health, your care, or payment for your care.

At a glance

Your Rights

When it comes to your health information, you have certain rights. This section explains your rights and some of our responsibilities to help you. To ask for a copy of your record, a correction, a limit on what we use or share, confidential communications, or a list of disclosures, please make your request in writing to our Privacy Officer, through the SimplePractice client portal, by email to admin@psychologicalhealing.net, or by mail to the mailing address at the top of this notice. If you need help putting a request in writing, ask us and we will help. You can ask for a paper copy of this notice, or make a complaint, in any way, including by phone.

Get an electronic or paper copy of your record

• You can ask to see or get an electronic or paper copy of your record and other health information we have about you. Send us a written request. You may also be able to view some information through the SimplePractice client portal.
• We will respond within the time the law requires. Under federal law, this is generally within 30 days, and some states require less time. In California, we will let you inspect your records within 5 working days and send you copies within 15 days of your request. Any fee will be reasonable and cost-based and will not exceed state limits. If you agree, we may give you a summary instead of a copy.
• In limited situations allowed by law, we may deny part of a request (for example, psychotherapy notes, or where a licensed professional determines access is reasonably likely to endanger the life or physical safety of you or someone else). If we deny your request, we will tell you why in writing and explain any right you have to have the denial reviewed.

Ask us to correct (amend) your record

• You can ask us, in writing, to correct health information about you that you think is incorrect or incomplete, and tell us why.
• We may say "no" to your request, but we will tell you why in writing within 60 days. You may then submit a statement of disagreement to be included with your record.

Request confidential communications

• You can ask us, in writing, to contact you in a specific way (for example, by cell phone rather than home phone, or only through the SimplePractice client portal) or to send mail to a different address.
• We will say "yes" to all reasonable requests. We will not ask you why.

How we communicate with you

• We use regular email and text message mainly for scheduling (for example, booking, changing, or confirming appointments). Please do not use email or text to tell us about an urgent concern. For clinical questions or documents, please use the SimplePractice client portal.
• Regular email and text message are not confidential. As explained on our consent forms, information sent this way could be read by others. If you prefer that we not contact you by email or text, tell us in writing and we will use another method.
• If you ask us to send you information by regular email (for example, a copy of your records or a Good Faith Estimate), we will do so after telling you about the risks. You can also ask us to communicate with you in other reasonable ways (see "Request confidential communications" above).
• Appointment reminders are sent by automated email through SimplePractice, our practice management system. Reminders contain appointment details only (such as the date and time) and no clinical information. You can ask us to stop these reminders or to send them a different way.
• SimplePractice client portal. We use the secure SimplePractice client portal for forms and documents and other secure communication with you.

Ask us to limit what we use or share

• You can ask us not to use or share certain health information for treatment, payment, or our operations. We are not required to agree to your request, and we may say "no" if it could affect your care. If we agree, we will honor the agreement except if you need emergency treatment or the law requires us to share the information.
• Self-pay restriction: If you pay for a service or health care item out of pocket in full, you can ask us not to share information about that service with your health insurer for the purpose of payment or our operations. We will say "yes" unless a law requires us to share that information.

Get a list of those with whom we've shared information (accounting of disclosures)

• You can ask for a list (accounting) of the times we have shared your health information for six years prior to the date you ask, who we shared it with, and why.
• We will include all the disclosures except for those about treatment, payment, and health care operations, and certain other disclosures (such as any you asked us to make). We will provide one accounting a year for free but will charge a reasonable, cost-based fee if you ask for another one within 12 months.

Get a copy of this privacy notice

• You can ask for a paper copy of this notice at any time, even if you have agreed to receive the notice electronically. We will provide you with a paper copy promptly. This notice is also posted on our website and is available at our office locations and on request.

Choose someone to act for you

• If someone has authority to act as your personal representative (for example, a legal guardian, a person with your health care power of attorney, or in many cases the parent of a minor), that person can exercise your rights and make choices about your health information.
• We will make sure the person has this authority and can act for you before we take any action. See "Minors" below for special rules that apply to teens.

Get notified of a breach

• You have the right to be notified if there is a breach of your unsecured health information. We will let you know promptly, as required by law.

File a complaint if you feel your rights are violated

• You can complain to us if you feel we have violated your rights by contacting our Privacy Officer using the information at the top of this notice.
• You can file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights by sending a letter to 200 Independence Avenue, S.W., Washington, D.C. 20201, calling 1-877-696-6775, or visiting www.hhs.gov/hipaa/filing-a-complaint/index.html.
• We will not retaliate against you for filing a complaint.

Your Choices

For certain health information, you can tell us your choices about what we share. If you have a clear preference for how we share your information in the situations described below, talk to us. Tell us what you want us to do, and we will follow your instructions.

In these cases, you have both the right and the choice to tell us to:

• Share information with your family, close friends, or others involved in your care or payment for your care.
• Share information in a disaster relief situation.

If you are not able to tell us your preference, for example if you are unconscious or in an emergency, we may go ahead and share your information if we believe it is in your best interest. We may also share your information when needed to lessen a serious and imminent threat to health or safety.

In these cases we never share your information unless you give us written permission (an "authorization"):

• Marketing purposes.
• Sale of your information.
• Most sharing of psychotherapy notes (see below).

We do not sell your health information.

Psychotherapy notes

"Psychotherapy notes" are notes a mental health professional may keep about the contents of counseling conversations that are kept separate from the rest of your record. Federal law (45 CFR 164.508(a)(2)) requires your written authorization for almost any use or disclosure of psychotherapy notes. The limited exceptions include use by the clinician who wrote the notes for your treatment; use in our own supervised training programs for mental health trainees; use to defend ourselves in a legal action or proceeding you bring; and certain disclosures required or permitted by law (for example, to HHS to investigate our compliance, to a health oversight agency for oversight of the clinician who wrote the notes, to a coroner or medical examiner, or to prevent or lessen a serious and imminent threat to health or safety).

Our clinicians may keep psychotherapy notes separately from the rest of your record. These notes receive the special protection described above.

Fundraising

We do not use your information for fundraising.

Our Uses and Disclosures

How do we typically use or share your health information?

Treat you

We can use your health information and share it with other professionals who are treating you. Example: With appropriate safeguards, your psychologist consults with your primary care physician or psychiatrist about your care, or we send the results of a pre-surgical psychological evaluation to the surgical team that referred you.

Run our organization (health care operations)

We can use and share your health information to run our practice, improve your care, train clinicians, and contact you when necessary. Example: We use health information to review the quality of care, to support clinical supervision and training, and to send you automated email appointment reminders.

Bill for your services (payment)

We can use and share your health information to bill and get payment from health plans or other entities. Example: We give information about you to your health insurance plan so it will pay for your services, or to confirm your coverage before a visit.

Business associates

We work with outside companies that perform services for us (for example, electronic health record, telehealth, billing, and scheduling vendors). We share information with them only as needed, and they must sign agreements to protect your information.

How else can we use or share your health information?

We are allowed or required to share your information in other ways, usually in ways that contribute to the public good, such as public health. We have to meet many conditions in the law before we can share your information for these purposes. Where a state law gives your information more protection than federal law, we follow the more protective law (see "State Law" below).

In all cases, including those listed below, if we have substance use disorder patient records about you that are subject to 42 CFR Part 2, we cannot use or share information in those records in civil, criminal, administrative, or legislative investigations or proceedings against you without (1) your written consent or (2) a court order and a subpoena.

Help with public health and safety issues

• Preventing disease.
• Reporting suspected abuse or neglect of a child, elder, or dependent adult, or domestic violence, as required or permitted by law.
• Preventing or reducing a serious threat to anyone's health or safety, as permitted or required by the law of the state where you receive care (see "State Law" below).
• Helping with product recalls and reporting adverse reactions to medications.

Do research

We do not use or share your information for research without your written authorization.

Comply with the law

We will share information about you if state or federal laws require it, including with the Department of Health and Human Services if it wants to see that we are complying with federal privacy law.

Respond to organ and tissue donation requests

We can share health information about you with organ procurement organizations.

Work with a medical examiner or funeral director

We can share health information with a coroner, medical examiner, or funeral director when an individual dies.

Address workers' compensation, law enforcement, and other government requests

• For workers' compensation claims.
• For law enforcement purposes or with a law enforcement official, as permitted by law, including the California limits described under "State Law" below.
• With health oversight agencies (such as state licensing boards) for activities authorized by law.
• For special government functions such as military, national security, and presidential protective services.

Respond to lawsuits and legal actions

We can share health information about you in response to a court or administrative order, or in response to a subpoena, as permitted by law, including the California limits described under "State Law" below. Mental health information may have additional protection under the psychotherapist-patient privilege and state law.

Other uses and disclosures require your written authorization

Uses and disclosures not described in this notice will be made only with your written authorization. This includes most uses and disclosures of psychotherapy notes, uses and disclosures for marketing, and sales of health information. If you give us an authorization, you may revoke it at any time by telling us in writing. Revocation will not affect any use or disclosure we already made in reliance on your authorization.

Minors

Some of our clinicians see adolescents. In general, a parent or legal guardian acts as the personal representative of a minor and may exercise the minor's privacy rights. However, state law may allow a minor to consent to their own mental health care, and in those cases the minor may control access to the related health information. In California, a minor 12 years of age or older may consent to outpatient mental health treatment or counseling if the treating professional believes the minor is mature enough to participate intelligently (Health and Safety Code 124260; Family Code 6924). The treatment must include involvement of the parent or guardian unless the treating professional, after consulting with the minor, determines that involvement would be inappropriate. In California, when a minor has lawfully consented to their own care, the parent or guardian does not have a right to see the records of that care, and we may also limit a parent's access when the law allows, to protect the minor's safety or well-being or the treatment relationship (Health and Safety Code 123110 and 123115). Our clinicians follow the minor consent and confidentiality laws of the state where the minor receives care. Other states have different rules (see "Other states" below).

State Law

California

Psychological Healing, Inc. is a California corporation, and many of our patients receive care in California. California law gives some health information more protection than federal law. Where California law is more protective, we follow it. For example:

• Confidentiality of Medical Information Act (California Civil Code 56 et seq.). In general, we will not share your medical information without your written authorization unless the law permits or requires it (for example, for your treatment, to obtain payment, or as required by law). We will not share your mental health treatment records without your written authorization unless it is for treatment or another law requires or permits us to share the information. When a person or entity that is otherwise allowed by law to receive information asks for information specifically about your outpatient treatment with a psychotherapist, California law (Civil Code 56.104) generally requires them to make a specific, signed written request, and to send you a copy of that request within 30 days after receiving the information, unless you have waived that notice in writing.
• Duty to protect (California Civil Code 43.92). If you (or in some cases a family member) communicate to your psychotherapist a serious threat of physical violence against a reasonably identifiable victim or victims, the psychotherapist may need to make reasonable efforts to communicate the threat to the victim or victims and to a law enforcement agency. California law also requires the psychotherapist to report the identity of the person making the threat to local law enforcement, which may result in a temporary prohibition on having firearms (Welfare and Institutions Code 8100 and 8105). California law also permits a psychotherapist to disclose information, in good faith, when necessary to prevent or lessen a serious and imminent threat to the health or safety of a reasonably foreseeable victim (Civil Code 56.10(c)(19)).
• Minors. See "Minors" above for California's rules on adolescents consenting to their own outpatient mental health care.
• Mandated reporting. California law requires our clinicians to report known or reasonably suspected abuse or neglect of children, elders, and dependent adults to the appropriate authorities.
• Gender-affirming and reproductive health care. California law limits our release of information about gender-affirming health care, gender-affirming mental health care, and abortion or abortion-related services in response to subpoenas, requests, or law enforcement inquiries based on another state's laws, and limits sharing of abortion-related information through electronic health records with people or entities in other states. We follow those limits (Civil Code 56.108, 56.109, and 56.110).

Other states

We provide care in person at our offices in multiple states and by telehealth. Our clinicians follow the privacy, confidentiality, minor consent, duty-to-protect, and mandated reporting laws of the state where you receive care whenever those laws are more protective of your information than federal law, or whenever those laws otherwise apply. For telehealth, the state where you receive care is the state where you are located during the session. If you have questions about how a particular state's law applies to you, contact our Privacy Officer.

Our Responsibilities

• We are required by law to maintain the privacy and security of your protected health information and to give you this notice of our legal duties and privacy practices.
• We will let you know promptly if a breach occurs that may have compromised the privacy or security of your information, as required by law.
• We must follow the duties and privacy practices described in this notice, as currently in effect, and give you a copy of it.
• We will not use or share your information other than as described in this notice unless you tell us we can in writing. If you tell us we can, you may change your mind at any time. Let us know in writing if you change your mind.

For more information, see: www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/noticepp.html

If you need this notice in an accessible format (for example, large print), ask us and we will provide it.

Changes to the Terms of This Notice

We reserve the right to change the terms of this notice, and the changes will apply to all information we have about you, including information we created or received before the change. If we change this notice, we will post the new notice on our website, and it will be available at our office locations and upon request; you can ask us for a copy at any time.

Effective Date

This notice is effective as of October 17, 2026.

Your Right to a Good Faith Estimate

Download the Good Faith Estimate notice (PDF)

Notice: Your Right to Receive a Good Faith Estimate

You have the right to receive a "Good Faith Estimate" explaining how much your health care will cost

Under the law, health care providers need to give patients who don't have certain types of health care coverage or who are not using certain types of health care coverage an estimate of their bill for health care items and services before those items or services are provided.

• You have the right to receive a Good Faith Estimate for the total expected cost of any health care items or services upon request or when scheduling such items or services. This includes related costs like medical tests, prescription drugs, equipment, and hospital fees.
• If you schedule a health care item or service at least 3 business days in advance, make sure your health care provider or facility gives you a Good Faith Estimate in writing within 1 business day after scheduling. If you schedule a health care item or service at least 10 business days in advance, make sure your health care provider or facility gives you a Good Faith Estimate in writing within 3 business days after scheduling. You can also ask any health care provider or facility for a Good Faith Estimate before you schedule an item or service. If you do, make sure the health care provider or facility gives you a Good Faith Estimate in writing within 3 business days after you ask.
• If you receive a bill that is at least $400 more for any provider or facility than your Good Faith Estimate from that provider or facility, you can dispute the bill.
• Make sure to save a copy or picture of your Good Faith Estimate.

For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises, email FederalPPDRQuestions@cms.hhs.gov, or call 1-800-985-3059.

To request a Good Faith Estimate from Psychological Healing, Inc.: contact Admin at admin@psychologicalhealing.net or 949-229-5820, or write to our mailing address (mail only; not a walk-in office): Psychological Healing, Inc., 20101 SW Birch Street, Suite #240, Newport Beach, CA 92660. If you have questions about the cost of your care, just ask. If you are uninsured or are not using insurance and you ask us about cost, we treat that as a request for a Good Faith Estimate.

If you need this notice in another language or in an accessible format (for example, large print), tell us and we will provide it at no cost to you.

Questions

For questions about this page, your privacy rights, or a Good Faith Estimate, contact us at admin@psychologicalhealing.net or 949-229-5820, or write to our mailing address (mail only; not a walk-in office): Psychological Healing, Inc., 20101 SW Birch Street, Suite #240, Newport Beach, CA 92660.