Arizona Smokers’ Helpline

How to Make Smoking Cessation Patient Referrals

The ASHLine referral program is a resource for healthcare providers and physicians to connect patients with a quit-tobacco program.

As a health professional, you can submit online or fax referrals to the ASHLine and we’ll call your patient within 1 business day hours to enroll him or her in our Quit Coaching smoking cessation 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 and get free medication if they qualify.

How to Make Referrals


Step 1: Set up your account

The first step is to create a WebQuit account with us where you can track your referrals. There are two ways to set up an account:

  • Call us at 1-800-55-66-222 x208
  • Or contact us and we’ll schedule a member of our team to call you

Step 2: Make a referral

You have two options for making a patient referral:

Option 1: Online

  1. Log in to WebQuit.
  2. Follow the instructions outlined in the WebQuit eReferral User Guide. Have questions? Call us at 1-800-55-66-222 x208, email us at, or Contact us for help.

Option 2: By Fax

  1. Download our fax referral forms (PDF) based on the language that your patient speaks.
  2. Complete the form. (Note that your patient must sign or give verbal consent.)
  3. Fax the form to us at 1-866-897-1263. Have questions? Contact us for help.

What Happens After a Referral

  • We will contact your patient within 1 business day (unless otherwise noted, i.e. “client is in
    hospital until next week”).
  • We will make a maximum of 7 attempts within 12 days to reach your patient.
  • IF REACHED, we will offer your patient free coaching, medication assistance and information about services.


Call 1-800-55-66-222 to get started.

Resources for You

Quitters can double their chances of quitting successfully by working with a Quit Coach.  

Learn about Quit Coaching