This form is a sample letter in Word format covering the subject matter of the title of the form.
Oklahoma Facsimile Cover Sheet
Category:
State:
Multi-State
Control #:
US-0021LTR
Format:
Word;
Rich Text
Instant download
Description
How to fill out Facsimile Cover Sheet?
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FAQ
Use specific language, like ?This fax contains confidential information intended solely for the individual or entity named above. Unauthorized disclosure, copying, or distribution is prohibited.? Place this fax cover sheet confidentiality statement in a prominent place.
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.
Both physical and digital faxes require cover sheets if they contain PHI. The information on the sheet is essential to alert the receiver of the private nature of the faxed document.
HIPAA Fax Disclaimer Examples This document is intended for [NAME] only. If you are not the intended recipient, you are hereby notified that any disclosure or distribution of this information is in violation of HIPAA confidentiality and prohibited.
A fax cover sheet typically includes the recipient's name and fax number, the sender's name and fax number, the number of pages being sent, and a brief message or subject line. It may also include the date, the fax machine's phone number, and any additional information or instructions.
