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 Phoenix
Category:
State:
Multi-State
City:
Phoenix
Control #:
US-0021LTR
Format:
Word;
Rich Text
Instant download
Description
Form popularity
FAQ
Create a Fax Cover Sheet for Confidential Documents in 7 Steps Add a Header With a Clear Subject and Mark It as Confidential. Add the Intended Recipient's Information To Ensure It Reaches the Right Person. Include the Date and Time of the Fax Transmission. Include a Brief Message With the Highlights of the Message.
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.
When sending a fax, include a cover sheet indicating the date and time sent; the recipient's name and fax number; and the sender's name, organization and phone number. The fax cover sheet should NEVER include a patient's name or any other PHI. 2. Include a privacy statement in the fax cover sheet.
Fax machines should be located in secure areas where the public cannot access it. Always use a fax cover sheet with a confidentiality statement. Verify the recipient information and consider using an online fax service for added security.
It's quick and easy to make a fax cover sheet like this while you're online. Choose one of our fax templates, and open it in Word for the web to make it yours. 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.
Electronic Faxing (eFax) You still use your recipient's fax number, but with efax, you can send from any internet-enabled device: desktops, laptops, tablets, or smartphones. If securely configured with encrypted transmission, electronic faxing can be HIPAA compliant.
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.
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.
More info
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. You have a right to ask for communications about your health and treatment to be confidential. 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. A fax cover sheet includes a 'Confidential' notice, indicating that the fax is meant solely for the designated recipient. File with Clerk of Superior Court. Social Security Numbers should appear on this form only and should be omitted from other court forms. Page 123 of 5 150 S. 12th St., Phoenix, AZ 85034 • Phone: • Fax: .
