Ordering Information for Quit Smoking Products

Call, mail, or fax the order forms below to:

AHRQ, P.O. Box 8547
Silver Spring, MD 20907-8547
1-800-358-9295

703-437-2078 (for callers outside of the United States)

703-437-6922 (Fax)

Name:
Credentials/Title:
Organization/Company:
Address 1:
Address 2:
City, State, Zip:
Phone number:
E-mail address:
Credit Card Information:
   Credit Card Type:  Mastercard   Visa
   Card Holder's Full Name:
   Credit Card Number:
   Expiration Date:

Please send me the following publications:

Pub. No. Title Cost1 Quantity Total
AHRQ 08-0050-2A Consumer Guide, Help for Smokers and Other Tobacco Users (English) 100 free/$12.50/25   $
AHRQ 08-0050-2B Consumer Guide, Help for Smokers and Other Tobacco Users (Spanish) 100 free/$12.50/25   $
AHRQ 03-0044 Hospital Card, Quitting Helps You Heal Faster (English/Spanish) 100 free/$15.00/100   $
AHRQ 02-0047 You Can Quit Smoking Card (English) 100 free/$15.00/100   $
AHRQ 03-0006 You Can Quit Smoking Card (Spanish) 100 free/$15.00/100   $
1Payment may be made via credit card (Visa/Mastercard) or checks payable to PPIP. Additional shipping charges may apply for bulk quantities and for delivery to addresses outside of the United States.

Quit Smoking Products for Clinicians

Call, mail, or fax the order forms below to:

AHRQ, P.O. Box 8547
Silver Spring, MD 20907-8547
1-800-358-9295

703-437-2078 (for callers outside of the United States)

703-437-6922 (Fax)

Name:
Credentials/Title:
Organization/Company:
Address 1:
Address 2:
City, State, Zip:
Phone number:
E-mail address:
Credit Card Information:
   Credit Card Type:  Mastercard   Visa
   Card Holder's Full Name:
   Credit Card Number:
   Expiration Date:

Please send me the following publications:

Pub. No. Title Cost1 Quantity Total
AHRQ 08(09)-0050-6 Quick Reference Guide for Clinicians, 2008 Update 100 free/$.50 ea   $
AHRQ 08-0050-3 Pocket Guide, Helping Smokers Quit: A Guide for Clinicians 100 free/$12.50/25   $
AHRQ 08(09)-0091-A Clinician Tear Sheet, Prenatal (English) 1 pad free/$.50 ea   $
AHRQ 08(09)-0091-B Clinician Tear Sheet, Prenatal (Spanish) 1 pad free/$.50 ea   $
AHRQ 08(09)-0092-A Clinician Tear Sheet, Primary Care (English) 1 pad free/$.50 ea   $
AHRQ 08(09)-0092-B Clinician Tear Sheet, Primary Care (Spanish) 1 pad free/$.50 ea   $
1Payment may be made via credit card (Visa/Mastercard) or checks payable to PPIP. Additional shipping charges may apply for bulk quantities and for delivery to addresses outside of the United States.
Page last reviewed December 2013
Internet Citation: Ordering Information for Quit Smoking Products. December 2013. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/professionals/clinicians-providers/guidelines-recommendations/tobacco/information/order.html