Forms

You may click on these to open in your browser or right click and save the linked file to your desktop.

Ontario Drug Benefit Pharmacist Smoking Cessation Program Forms

FAQ

Readiness Assessment

First Quit Consultation Meeting – My Quit Plan

Primary Follow-up Counselling Sessions 1-3

Secondary Follow-up Counselling Sessions 4-7

Program Evaluation

Fax Referral Form Quit Connection