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Referrals to State Quitlines An AtoZ Toolkit for Health Care & Social Service Professionals 2021 National Jewish Health 1400 Jackson Street Denver, CO 80206 www.nationaljewish.orgContents Introduction
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How to fill out referrals to state quitlines
How to fill out referrals to state quitlines
01
Gather all necessary information from the individual seeking help, including name, contact information, and smoking status.
02
Contact the specific state quitline to obtain the appropriate referral form.
03
Fill out the referral form with the individual's information and any relevant details about their smoking habits or history.
04
Submit the completed referral form to the state quitline through the designated process, whether it be online, by fax, or by mail.
05
Follow up with the individual to ensure they have connected with the state quitline and are receiving the support they need.
Who needs referrals to state quitlines?
01
Smokers who are looking to quit and could benefit from additional support and resources.
02
Healthcare providers who want to assist their patients in quitting smoking by referring them to professional quitline services.
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What is referrals to state quitlines?
Referrals to state quitlines are when individuals are directed to call state quitline services for support in quitting smoking or using tobacco products.
Who is required to file referrals to state quitlines?
Healthcare providers, employers, and individuals who come into contact with tobacco users may be required to file referrals to state quitlines.
How to fill out referrals to state quitlines?
Referrals can typically be filled out online or over the phone by providing basic information about the individual being referred.
What is the purpose of referrals to state quitlines?
The purpose of referrals to state quitlines is to connect individuals with resources and support to help them quit using tobacco products.
What information must be reported on referrals to state quitlines?
Information such as the individual's name, contact information, tobacco use habits, and reason for referral may need to be reported on referrals to state quitlines.
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