Quitline Iowa Fax Referral Form

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Author: Iowa Department of Public Health

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Quitline Iowa Fax Referral Form 1 id2331

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Make fax referral a part of brief cessation counseling! The referred client will receive a call from Quitline to enroll them in free, phone-based cessation counseling. Their enrollment status is faxed back to the provider.

Program: Community Health

Submitted Date: Feb 16, 2011 | Modified Date: Sep 30, 2025

Primary Toolkit: Healthy Communities Toolkit | Secondary Toolkit: N/A

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Institution Type: State,

Keywords: Chronic Disease

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