Thank you for taking the time to tell us about your Smoking Status (whether you are a smoker, ex-smoker or have never smoked). The process will only take a minute.
General Information:
|
Where do I find my Patient Number ?
If you do not know your Patient Number just leave this field blank as it is not mandatory, it
just helps us to identify you. However it is the 'Patient ID / Number' found on your
prescription slips if you have them.
Why do you need my Email Address ?
We use this to send you a confirmation of your smoking status. We do not store
your address on our system after the email has been sent. If you do not require a
confirmation email simply leave this field blank.
Other Notes:
All fields marked with * are mandatory.
|
|