
Quit-Now Referral Forms
With patient consent, mental health or medical providers can directly enroll patients to the QUIT-NOW free support for quitting nicotine using the following forms:
Email Referral Process QUIT-NOW
NM-Spanish-Fax-Referral-Form QUIT NOW
People are more likely to quit commercial tobacco/nicotine with the support of their healthcare provider. Direct enrollment removes barriers to help people who want to quit.
Description
With patient consent, mental health or medical providers can directly enroll patients to the QUIT-NOW free support for quitting nicotine using the following forms:
Email Referral Process QUIT-NOW
NM-Spanish-Fax-Referral-Form QUIT NOW
People are more likely to quit commercial tobacco/nicotine with the support of their healthcare provider. Direct enrollment removes barriers to help people who want to quit.