Confidential fax cover sheet for medical records
Confidential is ticked, so the confidentiality notice prints at the foot of the page. For your own records request or forms sent to a doctor's office or insurer.
FAX
ToFaxFromPhonePagesReMedical records request
UrgentConfidentialPlease reply
This fax may contain confidential information meant only for the recipient named above. If you received it by mistake, please tell the sender and destroy it.
What goes on a cover sheet
Who it's for and their fax number, who it's from and how to reach you, the page count including the cover, and a one-line subject. The page count lets the recipient see that nothing went missing.
Need the number? Find an official fax number in our directory, with the source and the date we checked it.
The cover sheet is made in your browser. Nothing you type is sent to us.