Tools for Providers

QuitWorks-NH provides tools to prompt staff to ask every patient about tobacco use. All tools are for use by any provider in any clinical setting.

Patient Referral Forms

QuitWorks provides customized referral forms to hospitals and health centers free of charge. Read more...

Tobacco Use Questionnaire

This simple questionnaire provides needed information on tobacco use and on whether the patient is thinking about quitting. It is administered when the patient checks in.

Download the Questionaire (PDF, 42 KB)

Pocket Guide

This is a quick guide to pharmacotherapy in tobacco treatment. It also lists the 5As to tobacco intervention.

Download the Pocket Guide (PDF, 115 KB)


NOTE: Adobe Acrobat Reader is required to view or print these documents. It can be downloaded for free from www.adobe.com.