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  • Indiana Tobacco Quitline Fax Referral Form Fax Number: 1-800 ...

Get Indiana Tobacco Quitline Fax Referral Form Fax Number: 1-800 ...

Indiana Tobacco Quitline FAX Referral Form Fax Number 1-800-483-3114 Fax Sent Date // Provider Information Clinic Name Health Care Provider Contact Name I am a HIPAA-Covered Entity Please check one Yes No I Don t Know Phone - Comments Patient Information Gender male / female Patient Name Address Primary Pregnant Y N Zip Secondary - Type HM WK CELL OTHER Language Preference check one English Spanish Other - Tobacco Type check ALL that apply Cigar.

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To enroll in This is Quitting, teens and young adults text DITCHVAPE to 88709.

This FREE service is available to Indiana Residents residents that make the call. Are you ready to stop smoking? Simply call 1-800-QUIT-NOW( 1-800-784-8669) or visit QuitNowIndiana.com.

West Virginia Tobacco QuitLine Call 877-966-8784 for more information.

What will I get if I text QUITNOW to 333888? You will get connected to free state or national text messaging services to help you quit smoking. Once you sign up for text messaging services, you will receive messages of encouragement, advice and tips for becoming smokefree and being healthier.

This FREE service is available to Indiana Residents residents that make the call. Are you ready to stop smoking? Simply call 1-800-QUIT-NOW( 1-800-784-8669) or visit QuitNowIndiana.com.

1-800-QUIT-NOW is the national portal to a network of state quitlines. Quitlines offer evidence-based support—like counseling, referrals to local programs, and free medication—to people who want to quit tobacco.

"The best way to quit smoking is with a combination of medication and counseling," says Maher Karam-Hage, M.D., medical director of the Tobacco Treatment Program at MD Anderson. "They both help. But you double your chances by using both compared with one of them."

For support in quitting, including free quit coaching, a free quit plan, free educational materials, and referrals to local resources, call 1-800-QUIT-NOW (1-800-784-8669). Information on cessation behaviors of U.S. adults and youth.

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© Copyright 1997-2025
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Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232