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Get the free Quitline Iowa Provider Proactive Referral Form - University of Iowa ... - healthcare...

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In partnership with: The University of Iowa College of Public Health, Department ... please include FAX number & provider name) ... By signing this form, I agree that: ... Adapted from: 2003 The State
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Quitline Iowa Provider Proactive is a program that assists healthcare providers in helping their patients quit smoking and other tobacco products. It provides resources, support, and counseling to individuals who want to quit.
Healthcare providers in Iowa are required to file Quitline Iowa Provider Proactive if they want to participate in the program and offer their patients the resources and support to quit smoking and other tobacco products.
To fill out Quitline Iowa Provider Proactive, healthcare providers need to complete the necessary forms and provide the requested information about their practice and patients. The forms can be obtained from the Quitline Iowa website or by contacting the program directly.
The purpose of Quitline Iowa Provider Proactive is to facilitate healthcare providers in offering effective tobacco cessation services to their patients. It aims to improve public health by reducing the prevalence of smoking and other tobacco use in the state.
Healthcare providers participating in Quitline Iowa Provider Proactive are required to report information such as the number of patients referred, the services provided, and the outcomes of the tobacco cessation interventions. Additional details may be requested by the program.
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