Congratulations on Becoming a Connect2Quit Provider!

As a Connect2Quit provider, you can directly refer your patients to quit services through Quit With Us, Louisiana making it easier and faster for them to start their journey to a tobacco-free life. The tools below will help you support your patients and encourage tobacco cessation at your facility.

Not already a Connect2Quit provider? Become one today!

Quit With Us, Louisiana Referral Form

The Quit With Us, Louisiana Referral Form allows you to link your patients directly to quit services through Quit With Us, Louisiana. Providers can submit patient referrals through the Quit With Us, Louisiana Online Referral Portal or fax completed forms to Quit With Us, Louisiana. A Quit Coach will contact your patient within 24 to 48 hours after the referral is processed to begin cessation counseling.

NOTE: During COVID-19 shelter-at-home, verbal consent is being allowed for the Connect2Quit program. Connect2Quit providers who wish to enroll patients through a telehealth visit can submit the Connect2Quit Verbal Consent Form.

On a bi-weekly basis, you will receive faxed Patient Progress Reports from Quit With Us, Louisiana. These reports detail progress throughout a patient’s quit journey.

Now that you’re a certified Connect2Quit provider, take the Brief Tobacco Intervention training to learn how to easily and effectively address patient tobacco use in less than three minutes.

Support Your Patients

Now that you’re a certified Connect2Quit provider, use these tools to connect your patients to important cessation resources to help them quit.

Pregnancy Cessation Brochure

Share the Pregnancy Cessation Brochure with your pregnant patients to highlight the specific benefits of quitting tobacco now to reduce current and long-term risks for their baby and improve delivery outcomes.

Quit With Us, Louisiana Signage

Post the Quit With Us, Louisiana flyers around your facility to encourage your patients to quit. These signs are 8.5″ x 11″ and easy to print, so use as many or as few as you’d like. Share with your team and patients that they can get support to quit tobacco.

Quit With Us, Louisiana Push Cards

Distribute these informational cards to your patients to give them more information on tobacco use risks and encourage them to quit. By providing these push cards, you’re helping your patients understand the risks of smoking to themselves and others and know that they have resources through Quit With Us, Louisiana to support their cessation.

Continuous learning is essential in healthcare. Join our Provider Education Network to get connected to resources and trainings to provide the best possible care to your patients and make every angle of your practice more effective.

Share with Your Organization

Everyone in your healthcare facility can take steps to support patients in quitting tobacco. Encourage your team to get involved by:

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