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Smokers Helpline Fax: 1 877 513-5334 CONFIDENTIAL Fax Referral Form Smokers Helpline 1 877 513-5333 www.cancer.ca HEALTH PROFESSIONAL REFERRAL SOURCE REQUIRED P LEASE PRINT PLEASE PRINT Health Professional
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What is smokers39 helpline fax referral?
Smokers39 helpline fax referral is a form used to refer individuals to a helpline for smoking cessation support.
Who is required to file smokers39 helpline fax referral?
Healthcare providers, employers, or other professionals who encounter individuals seeking help with quitting smoking are required to file smokers39 helpline fax referral.
How to fill out smokers39 helpline fax referral?
To fill out smokers39 helpline fax referral, providers need to include the individual's contact information, smoking history, reason for referral, and any relevant medical information.
What is the purpose of smokers39 helpline fax referral?
The purpose of smokers39 helpline fax referral is to connect individuals who want to quit smoking with resources and support to help them in their journey towards quitting.
What information must be reported on smokers39 helpline fax referral?
Information such as the individual's name, contact information, smoking habits, reason for referral, and any relevant medical history must be reported on smokers39 helpline fax referral.
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