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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.
1. About This Notice
Your Information. Your Rights. Our Responsibilities.
This notice is from AIM Microbiome, LLC, doing business as Avicenna Functional Medicine (“Avicenna,” “we,” “us,” or “our”). We are a functional medicine practice that sees patients by telehealth in Florida and Texas. This notice explains how we may use and share your health information, the rights you have over it, and our responsibilities to protect it.
It covers the health information we create or receive about you, including what you give us through our client portal. The portal is run by Practice Better, and it is where you book visits, complete intake forms and attend video visits.
Effective date: October 16, 2026.
If you have questions about this notice, or want to make any of the requests it describes, contact our Privacy Officer (see Section 9).
2. 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 use any of these rights, contact our Privacy Officer (see Section 9).
Get an electronic or paper copy of your medical record
- You can ask to see or get an electronic or paper copy of your medical record and other health information we have about you. Ask us how to do this.
- We will provide a copy or a summary of your health information, usually within 30 days of your request. We may charge a reasonable, cost-based fee.
Ask us to correct your medical record
- You can ask us to correct health information about you that you think is incorrect or incomplete. Ask us how to do this.
- We may say “no” to your request, but we’ll tell you why in writing within 60 days.
Request confidential communications
- You can ask us to contact you in a specific way (for example, at a particular phone number or email address) or to send mail to a different address.
- We will say “yes” to all reasonable requests.
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,” for example, if it could affect your care. If we agree, we may still share the information if you need emergency treatment.
- If you pay for a service or health care item out of pocket in full, you can ask us not to share that information with your health insurer for payment or our operations. We will say “yes” unless a law requires us to share that information. We do not bill insurance directly, but you still have this right.
Get a list of those with whom we’ve shared information
- You can ask for a list (accounting) of the times we’ve 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’ll 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.
Choose someone to act for you
- If someone has authority to act as your personal representative, such as if someone has your medical power of attorney or is your legal guardian, 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.
File a complaint if you feel your rights are violated
- You can complain if you feel we have violated your rights by contacting our Privacy Officer by email, phone or mail (see Section 9).
- 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.
- We will not retaliate against you for filing a complaint.
3. 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 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, 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:
- Marketing purposes
- Sale of your information
- Most sharing of psychotherapy notes
We never sell your information.
4. Our Uses and Disclosures
We typically use or share your health information in the following ways.
Treat you
We can use your health information and share it with other professionals who are treating you.
Example: We send a laboratory the information it needs to run tests we order for you, or we share your results with another clinician involved in your care.
Run our organization
We can use and share your health information to run our practice, improve your care, and contact you when necessary.
Example: We use health information about you to manage your treatment and services, including through our Practice Better client portal, where you book visits, complete intake forms and attend video visits.
Bill for your services
We can use and share your health information to bill you and get paid for our services. We are a cash-pay practice and do not bill insurance directly.
Example: We use your name and the services you received to process your payment, including payment from a health savings account (HSA) or flexible spending account (FSA).
6. Our Responsibilities
- We are required by law to maintain the privacy and security of your protected health information.
- We will let you know promptly if a breach occurs that may have compromised the privacy or security of your information.
- We must follow the duties and privacy practices described in this notice 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/hipaa/for-individuals/notice-privacy-practices.
7. State Law
Florida and Texas law may give you additional protections for your health information, and where state law is more protective than federal law, we follow it.
8. Changes to the Terms of This Notice
We can change the terms of this notice, and the changes will apply to all information we have about you. The new notice will be available upon request and on our website, and it will show the date it takes effect.
9. Contact Our Privacy Officer
To ask a question about this notice, make any of the requests it describes, or file a complaint with us, contact our Privacy Officer, Avicenna Functional Medicine, by phone or text at (689) 219-0409, or by email or mail:
AIM Microbiome, LLC, doing business as Avicenna Functional Medicine
- Email: info@avicenna.clinic
- Address: 3564 Avalon Park E Blvd, Suite 1-A882, Orlando, FL 32828
