Tobacco and Nicotine Dependence Treatment Information for Health Care Providers

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Health care providers will find information and resources here to help patients’ treatment efforts, including referral forms, and other resources. Please access the information through the links below.

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Web Referral Form

Use this online form to refer someone to the NDQuits program.

Print Referral Form

PDF form available for referral purposes.

Materials Order Form

Online request form for materials relating to NDQuits.