How To Refer
“Taking just a few minutes to talk to your patients about smoking can double the odds of them successfully quitting.” – Former Surgeon General Regina Benjamin, M.D.
How to Refer Throughout the Quitting Journey
Positive reinforcement and provider referrals are critical for all patients who use tobacco.
- All Patients
- Short on time with a patient who’s ready to quit?
- Refer them to 802quits.org to get help quitting, including free nicotine replacement therapy.
- Download the fax referral form (PDF) or send one electronically during the appointment.
- If you would like your patient to receive NRT and they have any of the following contraindications, we recommend you print and sign the Authorization to Disclose Health Information form and fax along with the referral form. Contraindications: heart disease or conditions, uncontrolled high blood pressure, stroke or heart attack in the last 12 months, pregnant or breast feeding.
- Contact a Vermont Quit Partner in your area and ask them to follow-up with the patient. Most are in the nearby hospital or clinic.
- Refer your patient to the MAT coordinator in your practice or department for additional quit support (if applicable).
Let your patients know that 802Quits offers free quit medications and cessation support in-person, by phone or online.