Confidentiality statement: Position the confidentiality statement near the bottom of the cover sheet or in a footer. Place this fax cover sheet confidentiality statement in a prominent place.For example, you can put it near the bottom of the cover sheet or in a footer. Use short, descriptive labels to convey the information. The information contained in this facsimile transmission is privileged and confidential and is intended only for the use of the recipient listed above. Complete all information on the form. The HIPAA Notice of Confidentiality must appear on the top of the fax transmission cover sheet: Enter on the fax cover sheet: "CONFIDENTIAL". A fax cover sheet includes a 'Confidential' notice, indicating that the fax is meant solely for the designated recipient. BW9-2, Request for Omission.