Request a Tobacco Cessation Box 

About You and Your Practice

Your response will help us fulfill your order and ensure the long term availability of these free tobacco cessation resources.
We may contact your practice's clinical lead for feedback on how our tools are used at point-of-care.

Your Order

RECOMMENDED: Order 1 pad for every 50 patients who need tobacco counseling in a six month period. So if your practice has about 200 TC patients in a 6 months period, order 4 pads, 2000 TC patients in that time, order 40 pads.
RECOMMENDED: Order 1 per practice site. This request if for a physical copy of the toolkit. A digital version is available to you on our website.
RECOMMENDED: Order 1 badge per provider
If shipping to a clinic or office, please include full details of office or mailbox number, building name, etc.