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Tennessee Tobacco QuitLine Fax Referral/Consent Form Health Care Provider Information – Please Print Health Care Provider ( First Last, Title): Fax Number: ( Phone: (
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Document Date: 2014-07-28 15:57:28
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File Size: 153,47 KB
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City
Ridgeland /
/
/
IndustryTerm
healthcare /
/
MedicalCondition
MS /
/
MedicalTreatment
counseling /
/
/
ProvinceOrState
Tennessee /
Mississippi /
/
URL
www.tnquitline.org /
/
SocialTag
Health
Medicine
Information & Quality Healthcare
Madison County, Mississippi
Peer review
Quitline
Fax
Email
Referral
Smoking cessation