Step-by-Step Guide for Online Referral Portal in Quit Services
Access the online referral portal for quit services to refer patients effectively. Follow the detailed instructions for referral partners, including selecting the patient's state, searching for facilities and healthcare professionals, completing the referral form, and submitting it securely. Thank you for facilitating your patients' access to state quit services.
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Online Referral Portal for Quit Services: Instructions for Referral Partners
1. Go to https://q4l.force.com/referral/s/ (bookmark this page!). 2. Choose your patient s state of residence, and confirm state when prompted.
3. Click Search Referring Facility (or indicate that you are not affiliated with a facility).
4. Search for the facility with which you are affiliated. If you have your facilitys NPI number, enter it and click Search . Otherwise, search with a combination of facility name, ZIP code, and/or fax number.
5. Scroll to select from the search results. If there is no match, click New Facility.
(If applicable, complete the form with information about your facility.)
6. Click Search Healthcare Professional. Follow the same process as with Referring Facility (i.e., search by NPI first, add a new record if no match).
7. Complete the referral form with your patients information and indicate if (and how) you would like to receive an outcome report for the referral.
8. Once you have completed the form (and verified that you are not a robot), click Submit . Thank you for referring your patient to their state s quit services!