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QUITS REFERRAL NORTH DAKOTA DEPARTMENT OF HEALTH TOBACCO PREVENTION AND CONTROL SON 59499 (92015) Please fax to Quit 1.855.997.8487 (185599 QUITS) or NDH IN Direct email DDH. Quits direct.DDH.ndhin.com
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How to fill out ndquits referral - nd
How to fill out ndquits referral - nd:
01
Start by accessing the ndquits referral form, which can be found on the official ndquits website.
02
Provide your personal information, including your name, address, phone number, and email address.
03
Indicate whether you are a tobacco user and the type of tobacco product you use (such as cigarettes, e-cigarettes, or smokeless tobacco).
04
Specify if you are a resident of North Dakota.
05
Choose your preferred method of contact (phone call, text message, or email) for receiving quit coaching services.
06
Answer the medical eligibility questions honestly and accurately to determine if you are eligible for the program.
07
Agree to the terms and conditions of the ndquits program.
08
Finally, submit the referral form and wait for further instructions from the ndquits team.
Who needs ndquits referral - nd:
01
Individuals in North Dakota who are tobacco users and want to quit can benefit from ndquits referral - nd.
02
This referral is suitable for people who are motivated to quit tobacco and are looking for professional quit coaching services.
03
It is especially helpful for individuals who have tried quitting in the past but have not been successful and may need additional support and guidance.
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What is ndquits referral - nd?
Ndquits referral - nd is a form used to refer individuals to quit smoking programs provided by the National Department of Health (ND).
Who is required to file ndquits referral - nd?
Health care providers, employers, and individuals can file ndquits referral - nd on behalf of tobacco users who want to quit smoking.
How to fill out ndquits referral - nd?
Ndquits referral - nd can be filled out online on the National Department of Health's website or submitted in person at designated health facilities.
What is the purpose of ndquits referral - nd?
The purpose of ndquits referral - nd is to connect individuals who want to quit smoking with resources and support to help them achieve their goal.
What information must be reported on ndquits referral - nd?
Ndquits referral - nd requires basic personal information of the individual seeking to quit smoking, current smoking habits, and any previous quit attempts.
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