Fax cover sheet template
A fax cover sheet with to, from, fax and phone numbers, date, number of pages, a subject line, comments and an optional confidentiality notice.
- ๐บ๐ธ US format ยท Letter size
- Free
Fill in what you need. The preview updates as you type.
What you type is not saved on our server.
The cover sheet is page 1
Count it in the total so the receiver knows when all pages have arrived. For medical records, the confidentiality notice is expected under HIPAA; for everything else it is good manners and costs nothing.
1 / 1
FAX
Lee Design Studio LLC 123 Main St, Suite 200, Austin, TX 78701
| To | Taylor Kim, Acme Inc. | From | Jordan Lee |
|---|---|---|---|
| Fax | (555) 010-0101 | Fax | (555) 010-0002 |
| Phone | (555) 010-0100 | Phone | (555) 010-0000 |
| Date | October 5, 2026 | Pages | 4 (including this cover sheet) |
| Re | Signed contract, order 4471 | ||
| Action | โก Urgentย ย โก For reviewย ย โ Please replyย ย โก Please comment | ||
| Comments | Taylor, the signed contract and the revised delivery schedule follow. Please fax back the countersigned last page by Friday. | ||
Confidentiality notice: This fax contains confidential information intended only for the person or organization named above. It may be protected by law, including health or financial privacy rules. If you are not the intended recipient, any review, copying or distribution of this fax is prohibited. If you received this fax in error, please call the sender at the phone number above right away and destroy all pages.
How to use it
Type who the fax goes to and who it is from with both fax and phone numbers, the date, how many pages you are sending with the cover counted as page one, and a short Re line. Tick what you want the receiver to do and write anything they should know in the comments box. Print it and put it on top of the pages, or save the PDF and send it through an online fax service.
Leave the confidentiality notice on for medical, legal or financial pages; it tells anyone who gets the fax by mistake to call you and destroy it. Your company name goes under the big FAX title if you type it.
Things to watch
Double-check the recipient fax number before you send; a cover sheet with a notice does not undo a fax sent to the wrong office. Keep the transmission report with your copy. If the pages need a signature back, say so in the comments and give a deadline.
Calculators that go with this
Frequently asked questions
Do I still need a cover sheet with an online fax service?
Most services add a plain one, but it rarely has your phone number, the page count or a confidentiality notice. Attach this PDF as the first page and turn the service's cover off.
Is the confidentiality notice enough for HIPAA?
A notice on the cover is the usual practice for faxing health information, together with checking the number and sending to a fax that sits in a secure place. The notice does not replace those steps.
Can I leave the comments box blank?
Yes. The box stays as empty lines so you can write a note by hand after printing.
Is what I type saved anywhere?
No. Everything stays in your browser and nothing is sent to our server. If you refresh the page it is gone, so print, save a PDF or download the DOCX when you are done.