Free Fax Cover Sheet Sample Template

Fax Cover Sheet Sample

FAX

To: Dr. Emily Carter
Fax Number: (555) 123-4567
Phone Number: (555) 234-5678


From: [YOUR NAME]
Fax Number: 222 000 3333
Phone Number: [YOUR COMPANY NUMBER]


Date: August 19, 2050

Subject: Patient Medical Records

Number of Pages: 5 (Including Cover Sheet)


Message

Dear Dr. Carter,

Please find attached the medical records for patient Laura Johnson, including her recent lab results and prescription details.

Confidentiality Notice:
The information contained in this fax is intended only for the recipient named above and may be confidential or privileged. If you have received this fax in error, please notify the sender immediately by phone or fax and destroy all copies of the original message. Unauthorized use, disclosure, or distribution of this communication is prohibited.

Thank you for your attention to this matter.

Sincerely,

[YOUR NAME]
Medical Records Coordinator
[YOUR COMPANY NAME]

[YOUR COMPANY NUMBER]

[YOUR COMPANY EMAIL]

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