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 Tarrant
Category:
State:
Multi-State
County:
Tarrant
Control #:
US-0021LTR
Format:
Word;
Rich Text
Instant download
Description
Form popularity
FAQ
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.
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.
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.
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).
A HIPAA fax cover sheet disclaimer. 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.
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.
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.
Although the content of a narrative on a fax cover sheet is optional, it does help to use a few buzz words, and always make it easy for someone to contact you if they received the fax incorrectly. First of all, do not use the patient's name or other PHI in the subject line on the fax cover sheet.
