our health service
If you would like to make a referral for a patient, client, service user, please download this form and complete the required fields. For information on local stop smoking clinics please click here.
Induction Document for Stop Smoking Advisors
Stop Smoking Advisor Registration Form
Recommended NRT-Stop Smoking Medication Form
Delivery of Stop Smoking Services During COVID-19 (July 2020)
Breath Carbon Monoxide Testing and COVID-19 (July 2020)
SOP Delivery of Stop Smoking Services Using Telehealth/Attend Anywhere
Guidelines for Setting up and Delivering a Community Peer-Led Stop Smoking Programme
Client Information Leaflet
Information Systems Access Request Form
Third Party Access Request Form
New One to One Clinic Set-Up Form
Referral Source Set-Up Request Form
QuitManager Advisor User Guide V1.6
Guidance Notes
Guidance Note 1: Select Referral Source
Guidance Note 2: Management of Client Records
Guidance Note 3: Marking an Episode Complete
Guidance Note 4: Request Deletion of Record on QuitManager
Guidance Note 5: Episode Creation for Client with an Existing QuitManager Record
Guidance Note 6: Recording Session Notes
Guidance Note 7: Recording Medical History
Guidance Note 8: Calendar Use and Referral Module
Guidance Note 9: Raising Queries with the QuitManager SuperUser Team
Guidance Note 10: Use of Spontaneous Quit Button on QuitManager
You can access QuitManager tutorial videos at the links below;
Client Set Ups, Recording Sessions & Call Backs (Recorded on 21.01.2021)
Top Tips, Record Maintenance & Data Audit (Recorded on 21.01.2021)
Referral Module & Referral Processing (Recorded on 21.01.2021)
Benefits of Quitting
Decisional Balance Tool
Fagerstrom Test For Nicotine Dependence
Responses to Patients Heartsink Statements
Smoking Diary
Nicotine Replacement Therapy and Medications for the Treatment of Tobacco Dependence
Coping with Withdrawal Symptoms
We Can Quit - Community Facilitator Course Evaluation
We Can Quit - Participant Post Course Evaluation (Pilot Course 2021)
