California Smokers' Helpline: 1-800-NO-BUTTS
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Register for the Helpline Referral Service

Welcome to the California Smokers' Helpline web-based referral registration. This system offers health professionals a quick and easy method for referring their patients who use tobacco to free, clinically proven cessation services. Please note the following:

  • Please check the drop-down menus first to see if your organization is already registered. If so, any clinician employed by a registered organization may start referring patients at http://forms-nobutts.org/referral. It is not necessary to register each referring clinician with the same organization.
  • If your organization is not registered, start with the box labeled “Parent or Umbrella Organization”, which refers to a larger health system such as a hospital or public health department. If your “Parent or Umbrella Organization” is listed in the drop-down menu, select it and move on to the next box, “Referring Organization.” If your “Parent or Umbrella Organization” is not listed in the drop-down menu, click the “Not on list” box and type in the name of your “Parent or Umbrella Organization”.
  • Likewise with the “Referring Organization” box, check the drop-down menu to first to see if your referring organization is listed. If it is listed, it is not necessary to register and you may start referring patients immediately at http://forms-nobutts.org/referral. If your referring organization is is not listed in the drop-down menu, click the “Not on list” box and type in the name of your “Referring Organization”.
  • Complete the rest of the information and click “Submit”.

Important Technical Note: To view this page properly, you must enable Javascript and use one of the following browsers: Firefox, Chrome, or Internet Explorer 10 or above. If you continue to experience technical issues, contact your technical support team or the California Smokers’ Helpline at (858) 300-1010. You will be notified within 5 business days if your registration is approved.