Referral programsReferring patients is simple
Patient referral programs –
Our patient referral program is designed to be an adjunct to healthcare professionals' efforts to help their patients stop smoking. It ensures stop-smoking support is readily available to patients following their healthcare visit.Online referral site
HIPPA-compliant and password-protected application for directly referring patients.
The site offers aggregated reporting and individual patient activity reports.
Refer online
Fax referrals
Healthcare professionals have access to a health-site customized fax referral form to refer patients to the Quitline.
Faxed progress reports are sent twice per month.
Referral form
Progress report (sample)
Enterprise solutions in Opt-to-Quit™
Our Opt-to-Quit™ referral program offers a healthcare system-wide solution that ensures every tobacco-using patient is offered a referral to the Quitline.
More than 750 healthcare sites throughout New York State use our successful Patient Referral Program.
Patient referrals can be electronically transferred and patient activity reports are available online.
What to expect
We prepare your patients for success –
Once you refer a patient, a Quit Coach will call your patient within 48 hours of receiving your referral and offer Quitline services.
Individualized coaching will help motivate a quit attempt, prepare for the quit process, and avoid future relapse.
Medication supply and coverage –
Eligible patients will be offered a supply of nicotine replacement therapy (NRT). All patients will be advised to learn about their health plan cessation benefits, including stop-smoking medication coverage.
Patients will also be informed of additional support, like health plans and local programs, websites, and self-help materials.
Getting started
For more information about Opt-to-Quit™ or any of our patient referral options, please –Contact us
Testimonials
Patient Referral Success
THE BUFFALO NEWS – "A widow’s best advice to those who smoke? Quit."Mary M. of West Seneca, NY – a smoker for nearly 50 years and recently diagnosed with COPD – is now living a smoke-free life, thanks to a referral by her healthcare professional to the New York State Smokers’ Quitline.
Learn more about — Mary’s story
Physician Testimonial
Dan Croft, MD, MPH, a member of the New York State Smokers’ Quitline Physician Task Force, explains the value of patient referral programs.Learn more about — Our expert panel
Program Highlight
Opt-to-Quit™ and Stony Brook Children's Hospital partner to educate and improve family health with tobacco cessation support and guidance.
(Left) "Smoking Cessation and Breastfeeding: Good for Your Baby, Good for You,"
stonybrookchildrens, YouTube. Featuring Physician Task Force member and NYSSQL featured expert,
Dr. Rachel Boykan, MD, FAAP
Learn more about — Research article, Stony Brook and Opt-to-Quit™
Tell us what you think
Your feedback helps us support health care professionals like you.Sign up for our electronic newsletters
Featuring briefs on the latest topics and information geared to enhance tobacco cessation efforts in a healthcare setting.
Last updated 9/18/2023 8:41 AM
Follow us
News, program updates, and support to quit: