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Quitline Iowa Fax Referral Form

Description:

Make fax referral a part of brief cessation counseling! The referred client will receive a call from Quitline to enroll them in free, phone-based cessation counseling. Their enrollment status is faxed back to the provider.

Toolkit:

Healthy Communities

Keyword Area:

Chronic Disease

Jurisdiction:

Institutional Author:

Iowa Department of Public Health

Submitted:

02/16/2011

Modified:

03/03/2011

The NACCHO Toolbox is a repository of available resources to help local public health practitioners. Tools are produced by local, state, and federal agencies, as well as academic institutions and other stakeholders. The contents of this Toolbox are solely the responsibility of the authors and do not necessarily reflect any official recommendations of NACCHO. NACCHO makes no express or implied warranty with respect to the contents and disclaims liability for any damages arising from or connected to the use of the material in this Toolbox.