Notice of Privacy Practices
Optimal State Health / Ahmad Ibrahim, D.O., P.C.
Effective Date: April 20, 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.
About This Notice
Optimal State Health, a service of Ahmad Ibrahim, D.O., P.C., is required by the Health Insurance Portability and Accountability Act (HIPAA) to maintain the privacy of your Protected Health Information (PHI), to provide you with this notice of our legal duties and privacy practices, and to follow the terms of this notice.
Protected Health Information (PHI) includes any individually identifiable information about your health condition, the healthcare services you receive, or payment for healthcare services.
How We May Use and Disclose Your Health Information
We may use and disclose your PHI for the following purposes without your written authorization:
Treatment: We may use your health information to provide, coordinate, or manage your healthcare and related services. For example, we may share your lab results with you during a telehealth consultation, or use your medical history to develop your treatment plan.
Payment: We may use and disclose your health information to obtain payment for services provided to you. For example, we may share information with your payment processor to complete a transaction.
Healthcare Operations: We may use and disclose your health information for our healthcare operations, including quality assessment, staff training, and administrative functions necessary to run our practice.
As Required by Law: We will disclose your health information when required to do so by federal, state, or local law.
Public Health Activities: We may disclose your health information for public health activities, including reporting to public health authorities for the purpose of preventing or controlling disease, injury, or disability.
Health Oversight Activities: We may disclose your health information to a health oversight agency for activities authorized by law, including audits, investigations, and inspections.
Judicial and Administrative Proceedings: We may disclose your health information in response to a court order or administrative tribunal, or in response to a subpoena or other lawful process.
Law Enforcement: We may disclose your health information to a law enforcement official for purposes such as identifying or locating a suspect, fugitive, material witness, or missing person, or reporting certain types of wounds or physical injuries.
To Avert a Serious Threat to Health or Safety: We may use and disclose your health information when necessary to prevent a serious threat to your health and safety or the health and safety of others.
Uses and Disclosures Requiring Your Written Authorization
We will obtain your written authorization before using or disclosing your PHI for purposes other than those described above, including:
- Marketing purposes
- Sale of your PHI
- Most uses of psychotherapy notes (if applicable)
- Other uses and disclosures not described in this notice
You may revoke your authorization at any time by submitting a written request to our practice. Revocation will not affect any uses or disclosures made prior to the revocation.
Your Rights Regarding Your Health Information
You have the following rights with respect to your PHI:
Right to Access: You have the right to inspect and obtain a copy of your health information maintained by our practice. To request access, submit a written request to dr@optimalstatehealth.com. We may charge a reasonable fee for copying and mailing costs. We will respond to your request within 30 days.
Right to Amend: You have the right to request that we amend your health information if you believe it is incorrect or incomplete. To request an amendment, submit a written request to dr@optimalstatehealth.com explaining the reason for the amendment. We may deny your request in certain circumstances and will provide you with a written explanation if we do.
Right to an Accounting of Disclosures: You have the right to request an accounting of certain disclosures of your health information made by our practice. To request an accounting, submit a written request to dr@optimalstatehealth.com. The request must specify the time period (not to exceed six years prior to the date of the request).
Right to Request Restrictions: You have the right to request restrictions on certain uses and disclosures of your health information. We are not required to agree to all requests, but we will carefully consider each request. If we agree to a restriction, we will comply with it unless the information is needed for emergency treatment.
Right to Confidential Communications: You have the right to request that we communicate with you about your health information in a specific way or at a specific location. For example, you may request that we contact you only by email or at a specific phone number. We will accommodate reasonable requests.
Right to a Copy of This Notice: You have the right to obtain a paper or electronic copy of this notice at any time. To obtain a copy, contact us at support@optimalstatehealth.com.
Right to Be Notified of a Breach: You have the right to be notified in the event that we discover a breach of your unsecured PHI. We will notify you in accordance with HIPAA’s Breach Notification Rule and applicable state laws.
Our Responsibilities
We are required by law to:
- Maintain the privacy of your PHI
- Provide you with this notice of our legal duties and privacy practices with respect to your PHI
- Follow the terms of this notice currently in effect
- Notify you if we are unable to agree to a requested restriction on how your information is used or disclosed
- Notify you in the event of a breach of unsecured PHI
We reserve the right to change our privacy practices and the terms of this notice at any time. Any changes will apply to all PHI we maintain. A revised notice will be posted on our website and provided to you upon request.
How We Protect Your Information
We maintain administrative, technical, and physical safeguards to protect your PHI, including:
- All patient health information is stored in CharmHealth, a HIPAA-compliant electronic health record (EHR) system with data encryption in transit and at rest
- Access to patient records is restricted to authorized healthcare providers
- We have executed Business Associate Agreements (BAAs) with all third-party service providers that handle PHI on our behalf
- All telehealth consultations are conducted through HIPAA-compliant, encrypted platforms
- We maintain role-based access controls, automatic session timeouts, and secure audit logging
Complaints
If you believe your privacy rights have been violated, you may file a complaint with our practice or with the U.S. Department of Health and Human Services Office for Civil Rights.
To file a complaint with our practice:
Email: dr@optimalstatehealth.com
To file a complaint with the U.S. Department of Health and Human Services:
Office for Civil Rights
U.S. Department of Health and Human Services
200 Independence Avenue, S.W.
Washington, D.C. 20201
Toll-free: 1-877-696-6775
Website: hhs.gov/hipaa/filing-a-complaint
You will not be penalized or retaliated against for filing a complaint.
Contact Information
Optimal State Health
Ahmad Ibrahim, D.O., P.C.
Privacy Officer: Ahmad Ibrahim, D.O.
Registered office: 4140 Wildflower Way, La Verne, CA 91750
Email: dr@optimalstatehealth.com
Phone: 352-280-8222
Website: optimalstatehealth.com