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DELAWARE OUTLINE
FAX REFERRAL FORMDELAWARE HEALTH AND SOCIAL SERVICES
Division of Public Health
Tobacco Prevention and Control Programmed complete, please fax to: 18666887577PROVIDERDelaware Quit
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How to fill out delaware quitline
How to fill out delaware quitline
01
Gather all the necessary information such as your personal details, tobacco usage history, and any other relevant information.
02
Visit the official Delaware Quitline website.
03
Look for the option to 'Fill out Quitline form' or similar.
04
Click on the option to open the form.
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Fill out the form by providing the requested information accurately.
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Double-check your entries to ensure all information is correct.
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Submit the filled-out form online.
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Await a response from Delaware Quitline regarding further steps or services.
Who needs delaware quitline?
01
Individuals who are struggling with tobacco addiction and want to quit smoking.
02
Residents of Delaware who are looking for support and guidance to quit smoking.
03
People who are interested in accessing resources and services offered by Delaware Quitline.
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Anyone who wants assistance in combating nicotine addiction and improving their health.
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What is delaware quitline?
Delaware Quitline is a free telephone service that provides support and guidance to individuals looking to quit smoking and using tobacco products.
Who is required to file delaware quitline?
Individuals who reside in Delaware and are seeking assistance to quit smoking or using tobacco are encouraged to utilize the Delaware Quitline.
How to fill out delaware quitline?
To utilize the Delaware Quitline, individuals can call the service directly or visit their website to complete an online form for assistance.
What is the purpose of delaware quitline?
The purpose of the Delaware Quitline is to provide resources, counseling, and support to individuals who want to quit tobacco use and improve their health.
What information must be reported on delaware quitline?
Individuals must report their contact information, smoking history, readiness to quit, and any previous quit attempts when utilizing the Delaware Quitline.
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