Michigan Tobacco Quitline Resources for Health Care Professionals

The Michigan Tobacco Quitline offers free information and referral to all Michigan residents who want to quit using tobacco. Qualifying residents also may receive free one-on-one coaching and nicotine replacement therapy to help them quit. The Quitline is funded through the Michigan Department of Health and Human Services and is operated by the National Jewish Health, the premier medical and research institution focusing on respiratory diseases in the United States.

 

The Michigan Tobacco Quitline Fax Referral Program Makes It Easy!

The Michigan Tobacco Quitline offers a special "quick enroll" Fax Referral Program designed to help you quickly and easily enroll patients who use tobacco but are ready to quit in the next 30 days.

To enroll a patient, simply confirm that he or she is ready to quit within 30 days. Then, simply fill out a Fax Referral Form (below), and ask the patient to initial the consent box and sign the form, giving permission for the Quitline to call him or her.*

Fax the form to the number provided, and you're done! The Quitline will process your fax, and its trained Quit Coaches will take it from there.


*A provider signature is also needed if the patient is pregnant and/or has uncontrolled high blood pressure or heart disease and wants nicotine replacement therapy from the Quitline.