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FEC HA DE ENVOY: ___/___/___ Information Del provender DE services medicos:HOMBRE DE LA CLN ICA, EL CONSULTATION, LA ARABIA O EL HOSPITAL CDI GO POSTALOBLIGATORIO: SOY RNA ENTICED ALBERTA POR HIPAA
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How to fill out oregon quitline fax referral

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How to fill out oregon quitline fax referral

01
Obtain a referral form from Oregon Quitline.
02
Fill out your name, contact information, and best time to reach you.
03
Provide information about your tobacco use and reasons for seeking help.
04
Include any additional comments or concerns.
05
Fax the completed form to the number provided by Oregon Quitline.

Who needs oregon quitline fax referral?

01
Individuals who are seeking assistance or support to quit tobacco use may need Oregon Quitline fax referral.

What is Oregon Quitline Fax Referral in Spanish Form?

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Oregon quitline fax referral is a method to refer individuals to the state's quitline services for assistance with quitting smoking.
Healthcare providers and other organizations are required to file Oregon quitline fax referrals for individuals who may benefit from smoking cessation services.
Oregon quitline fax referral forms can be filled out with the individual's contact information, smoking history, and reason for referral before being faxed to the quitline.
The purpose of Oregon quitline fax referral is to connect individuals who want to quit smoking with resources and support to help them in their quit journey.
Information such as the individual's name, contact information, smoking habits, and reason for referral must be reported on Oregon quitline fax referral forms.
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