HIPAA Compliant Fax Cover Sheet

A HIPAA-compliant fax cover sheet appears at the very front of any fax containing PHI, identifying the sender and recipient and carrying a confidentiality disclaimer that helps satisfy the HIPAA requirement to safeguard PHI transmitted via fax.

See our HIPAA fax cover sheet guide for the full breakdown of what to include, required format, and sample disclaimer language.

• Label it clearly. Mark the sheet “Confidential” or “HIPAA-Protected,” so recipients know to handle it accordingly.
• Exclude patient information. Use a case or reference number instead of the patient’s name.
• Include a confidentiality disclaimer. State that the fax may contain PHI and explain what to do if it’s received by mistake.
• Verify the recipient’s fax number before sending, especially for new contacts.
• Fax using a HIPAA-compliant platform like iFax. A compliant cover sheet doesn’t make the transmission itself secure.