California Smokers' Helpline: 1-800-NO-BUTTS
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Refer Patients to the Helpline

This system provides health professionals with a quick and easy method for referring their patients/clients who use tobacco to free, clinically proven cessation services.

Simply complete steps 1, 2, and 3 below for each patient you refer, and click "Submit." Once the information is received, a Helpline representative will make five attempts to call the patient over one week.

If your parent or referring organization is not listed below, please visit our registration page here.

Important Technical Note: To view this page properly, you must enable Javascript and use one of the following browsers: Firefox, Chrome, or Internet Explorer 10 or above. If you continue to experience technical issues, contact your technical support team or the California Smokers Helpline at (858) 300-1010.

For instructions on how to bookmark this web page on your Android tablet, please click here: http://www.dummies.com/how-to/content/how-to-bookmark-a-web-page-on-your-android-tablet.html. For instructions on how to bookmark this web page on your iPad, please click here: http://www.dummies.com/how-to/content/how-to-use-bookmarks-on-the-ipad.html.

Thank you for referring your patients/clients to the California Smokers’ Helpline!

1. Provider Information

2. Patient Information

 
 
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3. Patient Consent