Client Questions

Suggested Answers

How do I know this is confidential?

It is our commitment to keep your personal information confidential.  Like your doctor’s office that maintains confidential medical records, we have a system that ensures privacy.  We use client identifiers  to keep track of your information in our database. If someone were to break into our computer system and steal our records, your confidentiality would be maintained, because only the identifiers would be available, not your name. The only way we can prove to you that your information is confidential is to have you call The University of Arizona, Arizona Smokers’ Helpline at 1-800-556-6222 and ask, “Could you please tell me if (fill in name here) has ever been in a quit tobacco program?”

Is someone going to call me later and ask a lot of personal questions?

Your responses on the intake form are most useful if we can determine the effectiveness of the program you attended. Therefore, we need to call about 4 months, 6 months, and 12 months after you started the program for a brief (5-10 minute) survey to find out about your tobacco use. Your signature on the second page of the form is your agreement to be contacted. This information is vital to determine program success rates.  Once we know which programs work, we are able to duplicate them and achieve greater success.

Why do we have to fill out a form?

All adult clients in cessation programs fill out the CIF.  There are many reasons for enrollment, continuing with the program, and completing the program.  Whether you quit tobacco, relapse or continue using tobacco is due to a variety of factors, and, your experience can be an example to future clients.  If you encounter problems, your difficulties may serve as a warning to other clients.  The more knowledge we have about your experience, the better able we are to help others.

Do I have to set a quit date?

Yes.  A quit date is important to help set a goal of quitting tobacco.  Many programs require a quit date as part of their curriculum.  Because the quit date gives an exact time when you quit, it helps us to determine a more exact period of time for abstinence.

Facilitator Questions

Suggested Answers

Should I save copies of the CIF?

Yes. It is important to copy the CIFs in case the originals are lost or destroyed.  If your Local Project has an administrative person who makes copies, then it is your responsibility to communicate with him/her about who copies the CIF forms before mailing. It depends on how your Local Project wants the paperwork processed.  Some Local Projects prefer that providers route all CIFs through the Cessation Coordinator or Project Coordinator.  Others do not have such a policy. Once the Local Project receives confirmation from TEPP that the original was received, the copied CIF should be shredded, to ensure confidentiality of records.

Where can I get training on using this form?

Most of the information about using the CIF can be found in this learning activity and at http://www.azteppdata.org/. It is necessary to complete the learning activities associated with the CIF in order to become a Treatment Specialist.  When you finish the online training and attend the in-person training (Practicum), you will role-play with other participants, including filling out the CIF. 

What if a client refuses to answer the identifying questions?

Reassure the client that the information is kept confidential.  Please refer to “How do I know this information is kept confidential?”.  Emphasize that the information is useful to us in evaluating what makes a cessation program successful.

Where can I get more copies of the CIF?

You can download customized CIFs online. If you are not able to find the CIF with your name, contact: http://www.azteppdata.org/clientintake/feedback.html for technical assistance.

What if a client returns after already completing the program?  Is this counted twice?

Clients may wish to return to a program for ongoing support, or attempt another quit.  “Episodes of service”are recorded to determine program productivity. 

Example: Dave Morris completes a six-week program and quits tobacco.  He returns a month after the program because he’s started using again.  He fills out another CIF  and completes the program, again quitting tobacco.  A week later, Dave calls his provider and says he is still having trouble because everyone he works with smokes.  The counselor suggests returning to the class and using it as a support group.  Dave returns, fills out another CIF, and continues coming to classes intermittently for the next two months.  He has now received three “episodes of service”.