Fax-to-Quit

Helpful Downloads

• Fax Referral Form
• Interactive Fax Referral Form
• Interactive Spanish Fax Referral Form
• Fax Referral Form for Asian Language QuitLine

The quicker way to help your patients quit tobacco

Physicians often tell us there’s just not enough time during most patient visits to adequately discuss tobacco cessation. That’s why we’ve created the Fax-to-Quit program - a quick and efficient way to refer those patients who are ready to quit to an evidence-based cessation service. You just fax a short, completed form to the Colorado Quitline and a Quitline representative directly follows up with patients. And remember, this small step goes a long way in ensuring the good health of those patients wanting to quit. They’re nine times more likely to quit when they use the free Colorado Quitline compared to quitting on their own. Click on the files under "Helpful Downloads" in this section for the fax referral forms.