571/545 Avenue K SE, Winter Haven FL 33880Mon-Fri: 9am-6pm | Walk-Ins: 9am-2pm | Sat-Sun: Appointment only
Call: 407-440-0708

Notice of Privacy Practices

Effective date: September 27, 2026

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.

Haven Marijuana Doctor (“Haven,” “we,” or “our”) is required by law to protect the privacy and security of your protected health information (“PHI”), give you this Notice of Privacy Practices, notify you following a breach of unsecured PHI when required by law, and follow the terms of the notice currently in effect. This notice applies to PHI maintained by Haven in connection with its medical evaluations, physician certifications, follow-up care, billing, and related practice activities. PHI includes information that identifies you and relates to your health, health care, or payment for care.

How we may use and disclose your information

Treatment: We may use your PHI and share it with health care professionals involved in your care. For example, we may review records supplied by another clinician, document your evaluation, coordinate follow-up care, or share relevant information with another treating provider.

Payment: We may use and disclose PHI to collect payment for services, process a transaction, or resolve a billing question. If a service is billed to a health plan, we may share information needed for that purpose, subject to your rights described below.

Health care operations: We may use and disclose PHI to operate Haven, improve care, train staff, conduct audits, obtain professional advice, manage records, and meet licensing and compliance obligations. Vendors that handle PHI on our behalf must protect it as required by applicable law.

Florida Medical Marijuana Use Registry

If an authorized physician determines that a certification is appropriate, we may enter, review, and update information in Florida’s Medical Marijuana Use Registry as required or permitted by Florida law. The registry is maintained by the Florida Department of Health. State law specifies who may access registry information and for what purposes, including certain qualified physicians, prescribing practitioners, medical marijuana treatment centers, regulators, and law enforcement agencies under defined circumstances.

Registry access and disclosures by the state are governed by Florida law. A medical evaluation or appointment does not guarantee a physician certification or registry identification card.

Other uses and disclosures permitted or required by law

Subject to applicable conditions and any stricter protections under Florida or federal law, we may use or disclose PHI:

To remind you about appointments or tell you about treatment alternatives or health-related services.

To a family member, caregiver, friend, or another person involved in your care or payment for your care, consistent with your preference and the law.

For disaster relief, when permitted by law.

For public health activities, such as reporting certain diseases, adverse events, or suspected abuse or neglect.

To health oversight agencies for authorized audits, investigations, inspections, or licensing activities.

For research when the legal requirements for doing so are met.

To comply with a law that requires disclosure.

To respond to a court or administrative order, subpoena, or other legal process when the applicable requirements are met.

For law enforcement purposes when permitted by law.

To avert a serious threat to health or safety when permitted by law.

To coroners, medical examiners, funeral directors, or organ procurement organizations when applicable.

For workers’ compensation or certain government functions when authorized by law.

We will apply any stricter confidentiality requirements that govern particular records. Florida law protects patient medical records, and Florida law separately restricts access to identifying information held in the Medical Marijuana Use Registry.

Substance use disorder records subject to 42 CFR Part 2

If we receive or maintain substance use disorder patient records protected by 42 CFR Part 2, additional federal protections apply. We will not use or disclose those records in civil, criminal, administrative, or legislative investigations or proceedings against you without your written consent or the court order and subpoena required by law. Other uses and disclosures of Part 2 records will follow the applicable consent and legal requirements.

Your choices and written authorization

You may tell us your preferences about sharing information with family, friends, caregivers, or others involved in your care. If you cannot tell us your preference, we may share relevant information when we determine that doing so is in your best interest or is otherwise permitted by law.

We generally need your written authorization for: Most uses or disclosures of psychotherapy notes, if we maintain them; uses or disclosures of PHI for marketing when authorization is required by law; a disclosure that constitutes a sale of PHI; and other uses or disclosures that are not described in this notice and are not otherwise permitted or required by law.

We do not sell patient medical records. You may revoke an authorization in writing at any time. Revocation does not undo a use or disclosure we already made in reliance on it.

Your rights concerning your health information

To exercise a right described below, contact our Privacy Officer using the information at the end of this notice. We may ask for a written request and information needed to verify your identity or authority.

Access your records

You may ask to inspect or receive an electronic or paper copy of PHI in your designated record set. We will respond within the time required by law. We may charge a fee permitted by applicable law and will explain any lawful reason for denying access.

Request a correction

You may ask us to amend information you believe is incorrect or incomplete. We may deny a request in circumstances allowed by law, but we will explain a denial in writing and describe any available next steps.

Request confidential communications

You may ask us to contact you in a particular way or at a different address—for example, to call a specified number rather than send mail to your home. We will accommodate reasonable requests.

Request a restriction

You may ask us to limit certain uses or disclosures for treatment, payment, or health care operations. We are generally not required to agree. However, if you pay in full, out of pocket for a service or health care item and request that we not disclose information about it to your health plan for payment or health care operations, we will honor that request unless disclosure is required by law. Please make this request when arranging payment so we can identify the information to be restricted.

Request an accounting of disclosures

You may ask for a list of certain disclosures of your PHI made during the six years before your request. The accounting excludes disclosures for treatment, payment, and health care operations and certain other disclosures excluded by law. One accounting in a 12-month period is free; a permitted fee may apply to additional requests.

Choose a personal representative

A person legally authorized to act for you, such as an appropriately authorized health care agent or legal guardian, may exercise your rights when permitted by law. We will verify that person’s authority before acting on a request.

Receive this notice

You may request a paper copy of this notice at any time, even if you previously agreed to receive it electronically. You may also discuss this notice with our Privacy Officer.

Receive breach notification

We will notify you following a breach of unsecured PHI when notification is required by law.

File a complaint

You may file a complaint with Haven or with the U.S. Department of Health and Human Services, Office for Civil Rights. We will not retaliate against you for filing a complaint.

Our responsibilities

We must protect the privacy and security of your PHI and follow this notice while it is in effect. We will not use or disclose your information in a way this notice does not describe unless you authorize it in writing or the law otherwise permits or requires it.

Changes to this notice

We may change this notice and make a revised notice effective for PHI we already maintain as well as PHI we receive in the future. The current notice will be available at our office, on request, and on our website.

Questions, requests, and complaints

Privacy Officer — Haven Marijuana Doctor

545 & 571 Ave K SE

Winter Haven, FL 33880

Phone: 863-251-5015

Email: info@faaamed.com

Website: https://havenmjd.com

You may also file a complaint with the U.S. Department of Health and Human Services, Office for Civil Rights, 200 Independence Avenue SW, Washington, DC 20201; 1-877-696-6775; hhs.gov/hipaa/filing-a-complaint.