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Sealed Medical and Health Information Cover Sheet under GR 33. (SMHI). Confidential Health Information Enclosed.Health care information is personal and sensitive. Instant access to fillable Microsoft Word or PDF forms. Minimize the risk of using outdated forms and eliminate rejected fillings. The fax cover sheet must include the following elements: 1. The fax cover sheet must include the following elements: 1. Type of information being sent. • total number of pages sent, including the cover sheet. Complete the Request for Accommodation form.