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Sample HIPAA Disclaimer If you have received this information in error, any review dissemination, distribution, or copying of this information is strictly prohibited. If you have received this transmission in error, please contact the sender to arrange for the destruction or return of the information.

Make sure the confidential statement is visible on the cover sheet. Double-check the recipient's contact information to ensure it is correct. Create a unique password for each fax transmission and share it only with the intended recipient. Use encryption when sending sensitive documents via fax.

What should I include on the fax cover page? Information about the sender: Name, Title, Fax Number, Phone Number. Information about the recipient: Name, Title, Fax Number, Phone Number. Information about the sender's company: Logo, Address, Website, Email Address, Phone Number.

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.

Where and how to put attention on a fax? The attention (?Attn?) will be followed by the name of the recipient. The ?Attn? line should always appear at the very top of the delivery address, just before the name of the person you're sending it to. Use a colon after ?Attn? to make it clearly readable.

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.com. 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.

Make sure it contains the following: Sender's name and contact information. ... Sender's company name and logo. ... Date and time of fax transmission. ... Total number of faxed pages. ... Recipient's name and contact information. ... Confidentiality notice. ... Summary or description. ... Relevant notes.

An example of a fax disclaimer statement: This facsimile transmission contains information, which is confidential and/or privileged. This information is intended for use only by the addressee indicated above.