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How to Refer to the Quitline
The Quitline offers a Direct Referral Program designed to assist you in supporting smoking cessation among your patients. The Indiana Tobacco Quitline is FREE to your Indiana patients, staffed by professionally trained Quit Coaches. Patients who receive cessation advice from a physician are more likely to try to quit tobacco and have a greater chance of success.
Incorporating the Direct Referral Program into your practice is easy. Just follow these steps:
| ASK | ADVISE | REFER |
|---|---|---|
| Ask your patient about their tobacco use and document their response. |
Advise your patient to quit and assess their readiness to quit within the next 30 days and their interest in receiving phone counseling. |
Refer your pateint to the Indiana Tobacco Quitline! If your patient is ready to quit, fill out the referral form along with your patient and have them sign for consent. |
- Fax the form to: 1-800-483-3114.
- Discuss medication options with your patient.
- Evaluate the quit attempt with a follow up.
- We'll take it from there - It's that simple! The Indiana Tobacco Quitline will send a report back to your office to be placed in your patient's file. The report will tell you whether or not the patient was reached, enrolled in services and planned to quit.
Online Provider Referral Portal
Providers can now easliy and quickly refer patients through the Indiana Tobacco Quitline's online referral portal.
Visit QuitNowReferral.com to access the online portal.
Electronically Refer Patients to the Indiana Tobacco Quitline
Electronic Health Records represent an important new way for the Indiana Tobacco Quitline to receive referrals from health care providers. TPC is available to help health care systems in Indiana develop the capacity to refer tobacco users to the Indiana Tobacco Quitline through the health care system's electronic health records (EHRs).
For further information, please email tpcquitlinereferral@isdh.in.gov or call 317-234-1787.