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Indiana Tobacco QuitlinePatient ID#CLINIC FAX REFERRAL FORM FAX 1.800.483.3114 Indiana's Tobacco QuitlineClinicDate Fax Sent / / PROVIDER INFORMATION DentaQuest MRS Clinic Name Health Care Provider
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How to fill out date fax sent

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To fill out the date fax sent, follow these steps:
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Start by opening the fax cover sheet or document that needs to be sent.
03
Locate the section or field where the date fax sent needs to be filled in.
04
Take note of the required date format (e.g., MM/DD/YYYY or DD/MM/YYYY).
05
Using a pen or keyboard, enter the appropriate date in the specified format.
06
Double-check the entered date for accuracy.
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Save the changes made to the document or fax cover sheet, if necessary.
08
Send the fax as per your regular procedure, ensuring the designated recipient's fax number is correct.
09
Keep a record of the sent fax, including the date fax sent, for future reference if needed.

Who needs date fax sent?

01
Various individuals or organizations may need to provide or record the date fax sent, including:
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- Office administrators or support staff responsible for handling and tracking fax communications.
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- Legal professionals who require accurate documentation of when certain documents were sent.
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- Medical professionals for maintaining a record of faxed patient information or prescriptions.
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- Government agencies dealing with sensitive information that must be timestamped for security purposes.
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- Businesses or individuals involved in legal or contractual exchanges via fax, where proof of delivery and date is crucial.
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- Any individual or organization that relies on fax communication as a formal or official means of document transmission.
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Date fax sent refers to the specific day on which a fax transmission was sent or transmitted to a recipient.
Individuals or entities that are submitting documents that require fax transmission as part of regulatory or compliance processes are typically required to file a date fax sent.
Fill out the date fax sent by entering the exact date when the fax was transmitted, usually in the MM/DD/YYYY format, and include any additional required details such as the recipient's information.
The purpose of date fax sent is to provide a formal record of when a fax was sent, which may be necessary for tracking, compliance, and verification purposes.
The date of transmission, the recipient's name and fax number, and possibly a brief description of the document being sent.
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