When You Talk, Patients Listen.
Discussing the benefits of quitting with your patients increases their chance of success. Thousands of Hoosiers want to stop; however, they need your support.
ASK, ADVISE, REFER
If a physician advises a patient to quit just one time, it increases their chance for success. In many cases, people need professional help to break free. View the Tobacco Cessation Guidelines.
Referring patients is easy with these three methods:
FAX REFERRAL
The Fax Referral Program is as simple as click, fill out the form and fax to Quit Now Indiana program services. This is a confidential service.
Discuss medication options with your patient
Print the Fax Referral form and fill out the form with your patient
Please include your name and fax number in the provider section.
Have your patient initial and sign the fax referral form for consent as required by HIPAA in the patient section.
Assist your patient in selecting the best time to quit
Fax the form to: 1-800-483-3114
Prescribe pharmacotherapy if appropriate
A coach will call the patient
Evaluate the quit attempt with a follow-up
No limit on patients referrals from healthcare providers
Fax referrals are this simple! Quit Now Indiana will send a report to your office for the patient's file. The report will tell you whether or not the patient was reached, enrolled in services and planned to quit.
ONLINE REFERRAL PORTAL
Research shows that 70% of all smokers want to quit. In many cases, people need professional help to succeed. If a physician advises a patient to quit just one time, it increases their chance for success.
1.800.Quit.Now is a frontline tool for helping tobacco users break their addiction. This is a free service, it’s effective and it’s confidential. Thousands of people have used the program.
The Online Referral Portal is free to use, and there is no charge to those who use tobacco. The Portal is a fast and easy way to get those who use tobacco on the path to a tobacco-free life.
Part of Quit Now Indiana cessation network.
ELECTRONIC REFERRAL SYSTEM
Healthcare providers can electronically refer patients for Quit Now Indiana services. Electronic Health Records (EHRs) represent an important new way for individuals to be referred to cessation programs by healthcare providers. QNI staff is available to help hospitals plan and implement an EHR referral system for seamless processing and reporting. For further information, please email tpcquitlinereferral@isdh.in.gov or call 317-234-1787.