PROVIDER REFERRALS
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 smokingstopshere.com 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 If your clinic/facility is not listed or the fax number is out-of-date, you can add a new clinic/facility record (there will be a link at the top of the search results).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 www.smokingstopshere.com.
- 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 mdh.tobaccocontrol@maryland.gov
Provider FAQs
What is Fax to Assist?
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
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.