Request a call

Roswell Park Cessation Services provides evidence-based, best practice telephone and web-based services for the following health plans, state quitlines, and employer-sponsored programs:
  • Affinity Health Plan
  • BlueCross BlueShield of Western New York
  • BlueShield of Northeastern New York
  • Capital District Physicians' Health Plan (CDPHP)
  • EmblemHealth
  • Independent Health
  • New Jersey Quitline
  • New York State Smokers’ Quitline
  • Roswell Park Comprehensive Cancer Center
  • Wegmans Food Inc.
To have a Quit Coach call you to see if you qualify for one of our programs, please fill out the following information.

Check all that apply:

Resident:



Health Plan:







Employee/Family of Employee:






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Name*:

 

Phone number*:

 

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Please note, fields marked with '*' are required to receive a call by a Quit Coach.