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How to fill out the Tobacco Attestation Form - My BenefitHelp Sites online
Filling out the Tobacco Attestation Form is an important step for employees seeking to receive credits for their tobacco use status. This guide provides clear, step-by-step instructions on how to complete the form accurately and submit it online.
Follow the steps to complete the Tobacco Attestation Form online.
- Click ‘Get Form’ button to access the Tobacco Attestation Form and open it in your preferred editor.
- Begin by filling out the employee information section. Provide your full name and contact number clearly.
- Next, review the Tobacco Use Status options. Check one of the boxes that best reflects your situation: either you do not use tobacco products or you are currently using them but will engage in the smoking cessation program.
- If you are a tobacco user, ensure that you are aware of the program details mentioned in the form and confirm that you will complete it by the specified deadline.
- Sign the form to confirm that the information you have provided is accurate and complete. Ensure that you also date your signature.
- Finally, save your changes, and if required, download or print the completed form. Submit it to Alyssa LaMon via email or fax by the deadline provided in the instructions.
Complete your Tobacco Attestation Form online today for a smooth submission process!
Successful intervention begins with identifying users and appropriate interventions based upon the patient's willingness to quit. The five major steps to intervention are the "5 A's": Ask, Advise, Assess, Assist, and Arrange. Ask - Identify and document tobacco use status for every patient at every visit.
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