Tools Order Form

Fax this order form to 866-560-9113 or call toll-free 1-800-978-8678 to request help in choosing QuitWorks tools that are right for you (office practice implementation starter kits, provider guidance materials and patient education pamphlets).

Download the order form:
PDF (52 kb)













IN COLLABORATION WITH:   Boston Public Health Commission   |   Blue Cross Blue Shield of Massachusetts   |   Fallon Community Health Plan  | 
Harvard Pilgrim Health Care  |  HealthNet Plan  |  Mass Health  |  Neighborhood Health Plan  |  Network Health  |  Tufts Health Plan