This is the For Providers page.

Skip to main content Smiling healthcare professional with stethoscope engages with an older woman and man. Text reads
A doctor in a white coat and stethoscope smiles while talking to a patient. The setting is a bright, clinical office. The tone is friendly and reassuring.

Refer a Patient

Health care providers understand the many health risks and negative impacts that smoking and other tobacco use can have on the patients they care for. Physicians and other healthcare professionals across the state regularly refer patients to the Tennessee Tobacco QuitLine to help their patients through our smoking cessation program and services.

We’re here to help. The Tennessee Tobacco QuitLine provides several convenient ways for healthcare providers to refer patients to our evidence-based tobacco treatment services.

Fax Referral Form: English or Spanish

Download the form by clicking on the appropriate one, and fax it to 1-800-692-9023. The QuitLine will attempt contact with your patients for enrollment in QuitLine services. Progress reports are available upon request.

Form for Tennessee Tobacco QuitLine referral. Includes fields for healthcare and patient information, consent for follow-up, and contact preferences.
Download
Form for Tennessee Tobacco QuitLine referral, in Spanish. Includes fields for healthcare provider and patient information. Contact consent options.
Download

Online Referral Portal

Click here to refer your patients through a secure online portal.

The QuitLine will attempt contact with your patients for enrollment in QuitLine services. Progress reports are also available through the portal.

Electronic Health Records Referral

The Tennessee Tobacco QuitLine can partner with interested healthcare providers or systems to develop an eReferral program through patients’ electronic health records. For more information, call 1-800-Quit-Now (1-800-784-8669) and press option #3.

Patient Education Materials

Secondhand smoke kills more than 750 Tennesseans every year. Physician practices and other providers can download, print and share these graphics. Use them as posters or flyers in patient waiting rooms to jumpstart the conversation about tobacco cessation for patients and their families.

A hand extinguishes a cigarette, accompanied by the text 'Never quit quitting. It's the only way to win.' Includes the Tennessee Tobacco QuitLine contact info.
Download
A hand is extinguishing a cigarette with text in Spanish urging to keep trying to quit smoking. Includes Tennessee Tobacco QuitLine info and TN Department of Health logo.
Download
Three children lie on grass smiling up at the camera. Text reads 'Kick the Habit,' promoting the Tennessee Tobacco QuitLine. Tone is hopeful and encouraging.
Download
Three smiling children lie on grass, heads close together. Text reads: 'Deja El Hábito.' Promotes quitting tobacco with Tennessee health resources.
Download