Smoking Cessation Referral Forms and Resources for Health Care Professionals

As a health care professional in Oxford County, Elgin County and St. Thomas, you play an important role in helping your patients quit smoking. See our Quitting Smoking page for our smoking cessation services. 


Resources for Health Professionals:


Referral Form for Health Care Providers:

If you have a patient interested in quitting smoking, you can fax the completed referral forms (below) to Southwestern Public Health. We will then follow up with the patient to register them for an upcoming workshop. If your patient attends the workshop, we will fax you a letter to let you know. 


For more information, call 1-800-922-0096 or email