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Order Form for Pharmacists
Materials English French
CTI Pharmacy Aids
Clinical Tobacco Intervention Education Kit for Pharmacists
What is CTI?
CTI Strategy for the Pharmacy Team Poster
Implementing CTI in Your Pharmacy
 
PATIENT HANDOUT MATERIALS
Frequently Asked Questions About Stopping Smoking (20 per order)
Stop Smoking Medications (20 per order)
Health Effects of Smoking and Tobacco Use (20 per order)
The 'Why' Test (20 per order)
“Your Guide to a Smoke Free Future” booklet (20 per order)
“Quit Plan” pad, 50 sheets/pad (1 per order)
 
 
 Pharmacist's Last Name
 		  First Name
 
 Pharmacy (optional)
 
 Street Address
 		 Town/City
 Postal Code
 
 Phone Number
 		  Fax Number
 
 Email Address
 
 
You must complete all required fields to register your order.
 
Your privacy is important to us. Some information you provide in this order form may be considered personal information. This information will be collected, used and shared for the sole purposes of processing your order and delivering Clinical Tobacco Intervention services, programs and publications to you.

Thank you for participating in the CTI Program.


  
This program is funded, in part by the Government of Ontario.

View CTI's Privacy Policy   Terms and Conditions.