Background

The Client Intake Form (CIF) is a questionnaire used to record information about tobacco cessation services provided through projects funded by the Arizona Department of Health Services Bureau of Tobacco Education and Prevention (ADHS-BTEP). The CIF is an instrument that can be used across various delivery methods, including group classes, the Arizona Smokers’ Helpline, one-on-one counseling, telephone contact, and single-session group counseling. The information provided by the CIF helps cessation facilitators and counselors to improve service delivery.

Before initiating tobacco cessation services through ADHS-BTEP–funded projects, cessation facilitators must achieve Tobacco Treatment Specialist Certification through The University of Arizona HealthCare Partnership and must register as facilitators* through www.azteppdata.org.

The Tobacco Treatment Specialist Certification Program provides strength in statewide programming. It promotes quality and continuity by assuring that statewide affiliates and personnel who deliver intensive tobacco cessation interventions have met a standard in evidence-based quality practice as recommended by the US Public Health Service Clinical Practice Guideline: Treating Tobacco Use And Dependence.  Moreover, Arizonans who wish to overcome tobacco dependence are supported with the best available evidence-based treatment.

*Registration through www.azteppdata.org provides facilitators with a unique identification number that is also used to coordinate clients’ medication orders through the ADHS-BTEP medication benefit.