Faxing Protected Health Information

To protect patient privacy when faxing protected health information (PHI), a fax cover sheet must be used with the following elements:

• Date of fax transmission
• Name of requestor and facility/organization
• Sender’s fax number
• Sender’s phone number
• Number of pages sent (including cover sheet)
• Confidentiality Notice which includes a statement regarding re-disclosure
• Statement regarding communications for misdirected faxes and destruction

A sample fax cover sheet for the Dean’s Office is available here

The corresponding HIPAA Privacy Policy can be found here