Yes! I'm familiar with the 5 A's

You're almost done−just follow the steps below to begin referring patients.

Referral fax service: 1-800-483-3114

  1. Download this fax form
  2. Type in your office information
  3. Start referring!

The Patient Materials section includes a brochure that's easy to download and provide to patients who want to use Quitline NC or find out more about quitting.