Making A Referral
Everyone can quit. You can help. We can show you how.
- New accounts call 1-800-55-66-222 x208
- Login if you're already registered.
The ASHLine referral system is a resource to connect your patients/clients to a quit tobacco program. As a health professional, you can submit online or fax referrals for patients/clients to the ASHLine, and we'll call within 24 hours of receiving the referral to enroll them in our quit tobacco coaching program.
Referring a patient to the ASHLine increases their likelihood of quitting and staying quit. ASHLine coaches support individuals throughout the quitting process, helping them develop a tobacco free lifestyle, as well as offer medication support for those who qualify.
A referral can be made two ways. A QuitFax form can be sent in to the ASHLine (available to download below), or an online referral can be made through our WebQuit system. You can start referring once we have activated your account. Contact ASHLine directly (800-55-66-222 x208) to get the online referral process started. After a referral has been made, ASHLine will send you a confirmation receipt, and you will be notified once contact with the client has been established.
Everything required to make a referral can be found below. ASK all your patients/clients about tobacco use at every visit. ADVISE all tobacco users to quit. And REFER those who are ready to quit to ASHLine!
QuitFax Referral Instructions
Download the instructions sheet which outlines the steps necessary to make either a fax or online referral.
QuitFax Referral Form
You can download the QuitFax fax sheet here.
Online Referral Instructions
Get started on an online referral by following the link below.
Contact Us To Make Referrals Online
Contact the ASHLine if you have any questions.