This form is a sample letter in Word format covering the subject matter of the title of the form.
Printable Fax Cover Sheet With Confidentiality Statement In Los Angeles
Category:
State:
Multi-State
County:
Los Angeles
Control #:
US-0021LTR
Format:
Word;
Rich Text
Instant download
Description
Form popularity
FAQ
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. You'll be on the Templates for Word page. In the list of categories, click Fax Covers. To print the fax cover sheet, press Ctrl+P, and wait for the Print dialog.
There is no official HIPAA cover sheet but the cover sheet should contain the following information to be considered HIPAA compliant: Date and Time Fax sent. Receiver name and fax #
The confidentiality notice should always appear on the fax's cover sheet, along with a notice of the intended recipients, their contact information, and the contact information of the sender. It is highly recommended that the word “confidential” appear prominently (in large type) on the cover page.
Fax technology is still used regularly in order to share sensitive data and critical documents securely across key industries like healthcare, law and manufacturing. To ensure fax messages reach the intended recipient, users must include fax cover sheets.
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.
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.
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.
What is Included on a Fax Cover Sheet? From: (your name). Fax: (your fax number). Phone: (your phone number). To: (the company or person who is receiving the fax message). Attn: (the specific person who needs to get the fax). Fax: (their fax number). Phone: (their phone number).
These fax cover page templates include space for your logo, your company name, and contact information like your phone number and email. You can also enter the number of pages in your fax and the subject. Explore more templates that you can use for your business.
The confidentiality notice should always appear on the fax's cover sheet, along with a notice of the intended recipients, their contact information, and the contact information of the sender. It is highly recommended that the word “confidential” appear prominently (in large type) on the cover page.
