compliance cover sheetHIPAA compliant

HIPAA Fax Cover Sheet

HIPAA requires a confidentiality notice on every fax containing protected health information (PHI). This cover sheet includes the required language.

Cover Sheet Preview

HIPAA fax cover sheet with required confidentiality notice
To
From
Date
Re:
Patient Name
DOB
Pages
Provider
Fax
HIPAA Confidentiality Notice
Misdirection Instructions

Fields Included

To
From
Date
Re:
Patient Name
DOB
Pages
Provider
Fax
HIPAA Confidentiality Notice
Misdirection Instructions

When to Use This Cover Sheet

Medical records
Prescriptions
Lab results
Insurance authorizations
Referral letters

How to Use with TigerFax

  1. 1

    Open TigerFax and compose a new fax

    Scan or upload your document as usual.

  2. 2

    Tap 'Add Cover Page'

    Select the HIPAA Fax Cover Sheet from TigerFax's built-in template library. Fill in the required fields directly in the app.

  3. 3

    Send your fax

    The cover page is automatically prepended to your fax. The recipient receives it as the first page.

Compliance note

This cover sheet includes HIPAA-required confidentiality language. TigerFax transmits all faxes over encrypted connections to support HIPAA compliance.

Use TigerFax's Built-In Cover Pages

Instead of printing and scanning a cover sheet, TigerFax adds it digitally — saving time and ensuring a clean, professional result every time.

Free to start · iOS only · No fax machine needed

FAQ: HIPAA Fax Cover Sheet

The HIPAA Fax Cover Sheet includes the following fields: To, From, Date, Re:, Patient Name, DOB, Pages, Provider, Fax, HIPAA Confidentiality Notice, Misdirection Instructions. These cover the essential information needed for professional fax transmission.

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