Make a professional referral
Please use the below form to make a patient referral to one of our Smokefree Hampshire stop smoking services.
Whilst many of these fields are optional, we do request you provide your referrer details, so that any clarifications can be made to aid in the correct triaging for the service user.
If you are a member of the public looking to stop smoking and request either face-to-face, telephone or online support, please use the form on our self-referrals page.
01264 563039 or 0800 772 3649
Smokefree Hampshire is your local stop smoking service commissioned by Hampshire County Council.