Notice of Privacy Practices – Darrow Jay Thom, M.D., Inc., A Medical Corporation

Effective Date: October 28, 2025

This Notice describes how medical information about you may be used and disclosed and how you can access this information. Please review it carefully.

Darrow Jay Thom, M.D., Inc., A Medical Corporation (“we,” “our,” or “the Practice”) provides psychiatric services under the practice name Renaissance of Mind. Renaissance of Mind is not a separate legal entity.

We are required by law to maintain the privacy and security of your protected health information (PHI), to provide you with this Notice of our legal duties and privacy practices, to follow the terms currently in effect, and to notify you in the event of a breach of unsecured protected health information as required by law.

This Practice complies with applicable federal and California privacy laws, including the Health Insurance Portability and Accountability Act (HIPAA) and the California Confidentiality of Medical Information Act (CMIA). Where California law provides greater privacy protections, those protections apply.

We reserve the right to revise this Notice. Any revisions will apply to all information we maintain and will be made available through the patient portal and upon request.

1. How We May Use and Disclose Your Information

Treatment

We may use and disclose your protected health information to provide, coordinate, or manage your psychiatric care. This may include communication with other healthcare providers involved in your treatment, when authorized by you or permitted by law.

Because services may be provided through secure telehealth platforms, your information may be transmitted electronically using encrypted technologies designed to comply with applicable privacy laws.

Payment

We may use limited information for billing, payment processing, and related administrative activities.

This Practice operates on a private-pay basis and does not submit claims to insurance plans or Medicare. However, information may be used to process payments for services provided.

Healthcare Operations

We may use your information for healthcare operations, including quality improvement, recordkeeping, legal compliance, risk management, and general administrative activities necessary to operate the Practice.

2. Other Permitted or Required Disclosures

We may disclose your information without your written authorization when required or permitted by law, including:

• To comply with legal proceedings or court orders
• To report suspected abuse, neglect, or domestic violence
• To prevent or lessen a serious and imminent threat to health or safety
• For public health activities
• For health oversight activities
• For certain law enforcement purposes

3. Uses and Disclosures Requiring Your Authorization

Uses and disclosures not described in this Notice will be made only with your written authorization.

We will not sell your protected health information or use it for marketing purposes without your written authorization.

You may revoke an authorization at any time in writing, except to the extent that we have already relied on it.

4. Your Rights Regarding Your Health Information

You have the right to:

• Inspect and obtain copies of your health records
• Request corrections or amendments to your medical record
• Request restrictions on certain uses or disclosures (we are not required to agree to all requests)
• Request confidential communications, such as receiving communications at an alternative address or phone number
• Receive an accounting of disclosures of your information
• Receive notification in the event of a breach of unsecured protected health information
• Receive a paper or electronic copy of this Notice at any time

Requests should be submitted in writing unless otherwise permitted by law.

5. Communications

The Practice primarily communicates through a secure patient portal.

Email or voicemail may be used for limited administrative purposes at the contact information you provide. Electronic communication may carry some risk despite reasonable safeguards.

Please do not use email or voicemail for urgent matters or detailed clinical information.

6. Business Associates

We may share protected health information with third-party service providers who assist in operating the Practice, such as electronic health record vendors, telehealth platforms, or payment processors. These providers are required to safeguard your information and operate under written agreements consistent with HIPAA requirements.

7. Medicare Status

This Practice has formally opted out of participation in the Medicare program in accordance with federal regulations. Services are provided on a private-pay basis.

8. Complaints

If you believe your privacy rights have been violated, you may file a complaint with:

Privacy Contact
Darrow Jay Thom, M.D.

Darrow Jay Thom, M.D., Inc., A Medical Corporation
4500 Park Granada Blvd, Suite 202
Calabasas, California 91302
Phone: (805) 505-1492

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

You will not be retaliated against for filing a complaint.