Refer your clients for proactive phone support

Any healthcare provider or allied health professional in Saskatchewan, Manitoba, Prince Edward Island or Yukon can refer their clients to Smokers’ Helpline using the online referral form below or by faxing a Quit Connection PDF referral form to 1-877-513-5334.

First Nation, Inuit, Métis and urban Indigenous clients

Any healthcare provider or allied health professional in Manitoba, British Columbia, Ontario and Saskatchewan can refer their First Nation, Inuit, Métis or urban Indigenous clients to Talk Tobacco.

Ontario

Phone support in Ontario is provided by the Health Connect Ontario Smoking Cessation Program. Clients can be referred to the service by faxing the Health Connect Ontario referral form to 1-877-356-1691.

Tips for making successful referrals:

  • Make a cessation intervention a systematic part of your care
  • Keep this referral form bookmarked or printed forms accessible and fully stocked
  • Photocopy the form with your contact information already filled out
  • Contact us to order promotional and support materials such as referral forms and Talk Tobacco referral cards
  • Before submitting, print the completed page and file the referral form with your client’s chart  

Healthcare provider information

Patient/client information

If yes, the patient/client referral will be referred to Talk Tobacco, a free Canadian Cancer Society confidential program offering culturally appropriate support and information about quitting smoking, vaping and commercial tobacco use to First Nations, Inuit, Métis and urban Indigenous communities.

A Quit Coach usually calls within 3 business days. When should we call?

Time of day

Consent to contact: