Refer a Patient
Healthcare providers understand the many health risks and negative impacts that smoking and other tobacco use can have on the patients they care for. Physicians and other healthcare professionals across the state regularly refer patients to the Alabama Tobacco Quitline to help their patients through our smoking cessation program and services.
We’re here to help. The Alabama Tobacco Quitline provides several convenient ways for healthcare providers to refer patients to our evidence-based tobacco treatment services.
Fax Referral Form: English or Spanish
Download the form by clicking on the appropriate one, and fax it to 1-800-692-9023. The quitline will attempt contact with your patients for enrollment in quitline services. Progress reports are available upon request.
Download: English
Download: Spanish
Online Referral Portal
Click here to refer your patients through a secure online portal.
The quitline will attempt contact with your patients for enrollment in
quitline services. Progress reports are also available through the portal.
Electronic Health Records Referral
The Alabama Tobacco Quitline can partner with interested healthcare providers or systems to develop an eReferral program through patients’ electronic health records. For more information, call 1-800-Quit-Now (1-800-784-8669) and press option #3.
Alabama Medicaid Tobacco Treatment Coverage
Medicaid Covered Services
Physicians can click to download this document containing information and instructions for Medicaid covered services.
Download: Smoking Cessation Services Guidance
Patient Education Materials
Secondhand smoke kills more than 750 Alabamians every year. Physician practices and other providers can download, print and share these graphics. Use them as posters or flyers in patient waiting rooms to jumpstart the conversation about tobacco cessation for patients and their families.
