Healthcare providers may refer patients to the Quitline by using this site's online referral form or fax referral form. Both forms are compliant with HIPAA regulations, confidential and easy to use. Healthcare providers may register on the Web site and refer patients and check their progress through an online process. If you prefer a paper referral, once you and your patient sign the form, it can be faxed to the Tobacco Quitline, allowing our staff to call your patient. Progress reports on the patient are available to the healthcare provider, if requested.
For more information contact the Alabama Tobacco Quitline at 1-800-784-8669.
Click here for the Online Referral Form or to become a registered healthcare provider.
Click here for the Fax Referral Form. (Spanish Fax/Referral Form)
Remember, any Alabamian can use the FREE phone or online counseling services and receive 4 weeks of FREE Nicotine Replacement Therapy patches (if medically eligible and enrolled in counseling) provided by Alabama QUITNOW. Call 1-800-QUITNOW or 1-800-784-8669 or for online counseling click here
Hours of Operation
Monday through Friday - 8 a.m. - 8 p.m.
Saturday - 9 a.m. - 5:30 p.m.
Sunday and after hours - Voicemail is available
Days of Operation
The Alabama Tobacco Quitline is open Monday through Saturday except for recognized holidays: Christmas Eve, Christmas Day, Martin Luther King Jr. Day, Memorial Day, Fourth of July, Labor Day, and Thanksgiving Day.
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