HIPAA Hospice Fax Cover Sheet

FAX

To: [RECIPIENT'S NAME]

Date: [DATE]

From: [YOUR NAME]

Company: [YOUR COMPANY NAME]

Re: HIPAA Hospice Information

Fax no. [FAX NO.]

Contact: [Your Company Number]

Message

This fax contains sensitive patient information related to hospice care. The information enclosed is intended only for the recipient named above and must be strictly kept confidential by HIPAA regulations.

Please review the attached patient care documentation for Jane Smith, DOB 01/02/1955, regarding her recent symptom management plan. Your input on the proposed medication adjustments by February 9, 2050, would be greatly appreciated to ensure seamless care coordination. Thank you for your prompt attention to this matter and for your ongoing commitment to providing compassionate care.

The shared information should not be disclosed, copied, or forwarded without explicit permission. If this fax has been received in error, kindly notify [YOUR NAME] from [YOUR COMPANY NAME] immediately.

Kind Regards,