Fax Referral Program

What is it?

A program designed to make it easy for health care providers to refer their patients/clients to QuitNow By Phone for assistance to quit smoking.

Three Easy Steps!

The program connects your client with a quit counsellor at QuitNow By Phone.

1. Download the Fax Referral Form and have it signed by your client/patient indicating the best time to be called at home. (You can also order pads of 25 Fax Referral Forms and we will ship them to you free).
2. Fax the form to QuitNow By Phone at 1.888.857.6555 for direct follow-up with your client/patient.
3. Request a status report if client/patient provides consent on referral form. You will be sent follow-up information on the services provided, including the type of service accepted and whether a quit date was set.

What services do patients/clients receive?

A quit counsellor will initiate a call to your patient based on their preferred availability. Patients/clients interested in quitting will be enrolled in the program and will receive at least five counselling and follow-up sessions, including:

• Development of a personalized quit plan
• Help with learning new skills and behaviours
• Information about pharmacotherapy options
• Calls on quit date and post-quit dates for support

Note: Once the program ends, patients/clients are encouraged to call back at any time for on-going support or relapse prevention.

How effective is it?

Based on extensive research from the US Clinical Practice Guidelines*, the evidence shows that QuitLines significantly increase quit rates when compared to minimal or no counselling interventions. Further, the addition of quitline counselling to quit smoking medications significantly improves quit rates compared to medication alone.

*Fiore M.C., et al. Clinical Practice Guideline: Treating Tobacco Use and Dependence. 2008 Update