Refer-To-Quit Online
We do the rest!
- Register here - contact quitsite@roswellpark.org
- Log-in to our secure refer-to-quit online form
- Refer your patients
- Check the status of your patients
Refer-To-Quit Online
The New York State Smokers’ Quitline Provider Referral Program
Step 1 - Register for the program
The Refer-to-quit Online program is secure and easy
To register, please email the New York State Smokers' Quitline,
quitsite@roswellpark.org.
Step 2 - Refer your patients
Sample Refer-To-Quit Log-in
1. Once registered, you will receive log-in information and link to a secure referral portal where you will refer your tobacco-using patients into New York State Smokers’ Quitline services.
Sample Refer-To-Quit Online Screen
2. Referrer completes form with information on tobacco user and verification of consent for the Quitline to contact. (See referral form)
3. Once referral is made, clients receive a call from a Quitline Quit Coach who will provide tailored coaching and screen for NRT eligibility.
4. If the Quit Coach is unable to reach the client by telephone after 5 attempts, a letter is sent encouraging the individual to contact the Quitline for assistance.
5. Eligible clients (regardless of their insurance) are sent a 2‐week supply of NRT (patches or gum) in the mail.