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Site Champion 

A site champion is a volunteer staff person who serves as the liaison between the medical office and the Center for Smoking Cessation’s Outreach Specialist.



three-femail-docsChampion Tools

Office Supplies

  Order Form
  Posters, brochures and self help materials 
  EHR - AAFP Recommendations
  Site Champion Job Description



  “30 Seconds to Save a Life” Agenda
  Book Site Training
  Clinician PHS Guideline Materials



  Fax-to-quit form

  Quitline Electronic Referrals


Billing information:

  Coding Information for Pediatric Visits
  Smoking Cessation Codes Summary
  Cessation Medication- Medicaid Coverage

  Cessation Counseling- Medicaid Coverage
  Cessation Medication & Counseling- Medicare Coverage


Chart Reviews

  Chart Review Instructions
  Chart Review Forms
  Time Sheet


21 CME  - Performance Improvement Program

  Program Overview
  Stage A
  Stage B
  Stage C
  Chart Review Form


Healthcare provider resources

  Pediatric Patients and Tobacco Use

  PACT - Professional Assisted Cessation Therapy



Winter 2010

Summer 2010

Fall 2010

Winter 2011

Summer 2011

Winter 2012

Spring 2012

Summer 2022

Fall 2012

Winter 2013



  Tobacco Free Periodicals
  Sample Policies