Congratulations on Becoming a Connect2Quit Provider!

As a Connect2Quit provider, you can directly refer your patients to the Louisiana Tobacco Quitline 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!

Louisiana Tobacco Quitline Referral Form

The Louisiana Tobacco Quitline Referral Form allows you to link your patients directly to the Louisiana Tobacco Quitline. Once it is completed and emailed or faxed to the Quitline, 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 the Quitline. These reports detail progress throughout a patient’s quit journey with the Quitline.

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

This brochure can be shared with your patients who are pregnant to highlight the specific benefits of quitting tobacco now to reduce current and long-term risks for their baby and improve the patient’s delivery outcomes.

Quit With Us, Louisiana Signage

Use these signs 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 to share with your team and patients that they can get support to quit tobacco.

Quit With Us, Louisiana Push Cards

These informational cards can be provided 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 like the Quitline 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:

Need Assistance? Connect with Us!