Order Form: Quit Partner™ Promotional Materials

Thank you for your interest in promoting Quit Partner programs. This form is for organizations who would like to order Quit Partner promotional materials to distribute to community members, clients, and patients.

The Minnesota Department of Health is offering limited printed Quit Partner promotional materials, free of charge.
Please visit the Quit Partner Downloadable Materials webpage for digital versions of these materials and more that you can download, share electronically, or print on your own.
Because we have a limited quantity of printed materials available, each item has a maximum quantity you can order. Please only order what you will use.

Quit Partner^TM Materials (adult program for ages 18 and up)

American Indian Quitline Materials

My Life, My Quit ^TM Materials (program for teens ages 13-17)

Contact Information

We will contact you if we have any questions about your order.

Name

Phone number

Email address

Mailing Address

Materials will be shipped to this address. We cannot ship to PO Boxes.

Name

Organization

Street address

City

State

Zip code

Additional Information

Optional questions

Comments or special instructions

Please share any recommendations for improving or expanding Quit Partner promotional materials

What organizations or associations do you think would like to know about these materials?

Additional Resources

Please visit the Quit Partner Downloadable Materials webpage for digital versions of these materials and more that you can share download, share electronically, or print on your own.

If you have questions, contact the Minnesota Department of Health Cessation Unit at cessation@state.mn.us or at 651-201-3535 or 866-901-8316. To request this form in another format, call 651-201-3535. Permission is given to photocopy the materials listed on this form.