As a trusted provider, you can help your patients by referring them to the Quitline. You can refer patients online, through an electronic health record, or through fax. Read more about each option below.

  • Go to and click the green “Enroll Now” button. Here, you’ll find the ‘Refer A Patient’ button in the top-right corner.
  • Search for your clinic or facility. If your clinic/facility is not listed or the fax number is out-of-date, you can add a new clinic/facility record (there will be a link at the top of the search results).
  • Once you have selected your clinic/facility, complete the referral form for the patient/client. You may also help them register for services directly on

  • Download the fax referral form.
  • Complete the Provider Information section at the top.
  • Save a copy and/or print copies with your information pre-populated.
  • Then, with each client you refer, complete the Patient Information section, and ensure that they provide their initials where indicated and sign/date the bottom.
  • Fax the completed, signed form to 1-800-483-3078.

  • Providers submit the referral via their EHR system securely and electronically to Quitline.
  • The Quitline reaches out to the patient and sends an outcome report back electronically to the provider’s EHR.
  • Click here for free training on referring patients through your EHR system.
  • For questions about connecting your EHR system to the Quitline, please contact

Provider FAQs

The Quitline is operated by Optum, a third-party provider of tobacco cessation counseling services. Optum operates over 20 state quitlines and is the largest quitline service provider in the United States.
Yes. The Maryland Tobacco Quitline (MDQL) provides free supported telephone- and web-based tobacco cessation coaching to all Marylanders beginning at age 13, including cessation medication support and education, nicotine replacement therapy (NRT), integrated text messaging support with a coach, printed materials, and referral to community resources.
Any provider can refer clients to the Quitline; there are no restrictions on who can make a referral. However, only HIPAA-governed facilities and organizations can receive referral outcome reports.
No. You must enroll in a quit program to get free nicotine replacement therapy (NRT). The Quitline pairs counseling with NRT because it increases your chances of quitting tobacco. If you do not want to enroll in a quit program, you may be able to get reimbursed for nicotine patches through your health insurance. Talk with your health insurance plan to see if this is an option for you.
Outcome reports are available for HIPAA-governed facilities and organizations. These reports are sent via fax to providers who indicate they are a HIPAA-covered entity on the referral form. Outcome reports include helpful follow-up information, including whether the Quitline was able to reach the client and, if so, whether the client enrolled in a program, the planned quit date, and if screening criteria for cessation medications were met. You can use this information to follow up with your client about their quit attempt at your next contact.

What is Fax to Assist?

Provider Enrollment

The Fax to Assist Program allows healthcare and non-healthcare professionals to refer individuals to free Maryland Tobacco Quitline services to become tobacco-free.

1Conduct a brief intervention to determine the individual’s readiness to quit tobacco

2Fill out the Fax to Assist referral form to enroll the individual in the Quitline services upon their consent

3Fax the referral form to Maryland Tobacco Quitline for the coach to contact the individual within 48 hours

4Receive confirmation of contact and fax-back reports on patient progress (HIPAA-covered entities only).

Within 48 hours, a certified coach will call your patient to begin the tobacco cessation coaching process. It’s that simple!

Guides for Cessation Services covered under Medicaid

Clinical Criteria for Medications

Medicaid Mental Health Formulary

Online Brief Tobacco Intervention Training in Maryland

The Maryland Tobacco Quitline’s new online brief tobacco intervention training features the abbreviated AAR – Ask, Advise, and Refer – intervention, referral methods for the Quitline, and pharmacology information as well as CME credits. Click here to access the training.

Helping your Patients Quit: A Systems Approach to Tobacco Cessation

Click here to watch the previously recorded webinar.