Request a quit pack - Cwmfelin Medical Centre

Use this form to request

We can only provide these to people living in Scotland.

To request a quit pack, please complete the following information and hit submit.

Title

First nameMaximum of 50 characters

Notes

Last nameMaximum of 50 characters

House name/numberMaximum of 50 characters

Street nameMaximum of 50 characters

TownMaximum of 30 characters

CityMaximum of 30 characters

Postcode

Age range

Under 16

16-17

18-24

25-34

35-44

45-59

60+

Please leave your email address to receive electronic copies of the publications, if you prefer.

Quit pack materials requested

iQuit – Stopping Smoking When You're Pregnant booklet

How to Stop Smoking and Stay Stopped booklet

Gender

Where did you hear about this service?