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. If this is your first time making a referral: Select Create New Agent and provide your information. (Keep track of your username and password to view your referral reports.)
    If you’ve made referrals before: Type your first name in the Agent field and press enter, wait 2-3 seconds, then select your name from the drop down menu.
  3. Select Create New Client to enter your patient’s information and press submit.
  4. Complete the remaining required fields in the online form and select Save.

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.

Not ready to call yet?

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Resources for You

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

Learn about Quit Coaching