This form is a sample letter in Word format covering the subject matter of the title of the form.
Fax Cover Sheet With Confidentiality Statement In Broward
Category:
State:
Multi-State
County:
Broward
Control #:
US-0021LTR
Format:
Word;
Rich Text
Instant download
Description
Form popularity
FAQ
A confidential fax cover sheet is the first page you send when faxing sensitive or private documents. It acts as a shield, letting anyone who sees it know the document is private.
The information is intended only for the use of the individual(s) or entity named above. If you are not the intended recipient, you are hereby notified that any disclosure, copying, distribution, or taking of any action in reliance on the contents of this facsimile information is strictly prohibited.
A HIPAA fax cover sheet disclaimer is a message addressed to the fax recipient, that states that the faxed information is confidential. The disclaimer also should state that the transmission may contain protected health information.
The information is intended only for the use of the individual(s) or entity named above. If you are not the intended recipient, you are hereby notified that any disclosure, copying, distribution, or taking of any action in reliance on the contents of this facsimile information is strictly prohibited.
A HIPAA compliant fax cover sheet should include sender and recipient details, date and time, a confidentiality statement, privacy notice, subject, page count, and optional disclaimers.
Some of the top items that need to be included in a HIPAA fax cover sheet are: A confidentiality statement: This statement explains that the information being faxed is confidential and should not be read by anyone other than the intended party.
To ensure HIPAA compliance, you will need a cloud fax service that will sign Business Associate Agreement (BAA) to ensure proper handling of all information to prevent access by unauthorized parties. This agreement is a requirement perHITECH and must be a feature of any online fax service you choose.
An example of a fax disclaimer statement: If you are not the intended recipient, please be advised that any disclosure, copying, distribution, or use of the contents of this information is strictly prohibited, and that any misdirected or improperly received information must be returned to this company immediately.
A fax cover sheet typically has basic contact information: who the fax is going to, who the fax is from, the subject matter, how many pages are included, company name (address is optional), a telephone number, and a check box to mark whether it's urgent or needs a reply.
It's quick and easy to make a fax cover sheet like this while you're online. Choose one of our fax templates, and open it in Word for the web to make it yours. Tip: If you're already in Word for the web, get to the fax templates by going to File > New, and then below the template images click More on Office.
