Contact Us

For information about the OHSU Tobacco-Free Policy, please go to www.ohsu.edu/tobaccofree.

To talk to a wellness staff member about managing your cravings at work, getting quit meds, or about quitting tobacco, please fill out the form below and someone will contact you within two business days. If your matter is urgent, call 503 494-WELL (9355).

Thanks for taking a few minutes to fill out this form. It will help us get you the support and resources that you want more quickly.

Please check one of the following:

  OHSU Employee (benefited or non-benefited)
  OHSU Student
  OHSU Volunteer
  Family Member of OHSU Employee (covered under benefit plan)

First Name
Last Name
Job Title
Department
Email address
(Best one to use to reach you)
Phone 1
(Best number to reach you)
Phone 2
(Next best number)

Program Option: Check all that interest you. (If you do not check an option, no need to fill out information in that section.)
  Option 1: Appointment with tobacco free support specialist
  By phone
  In person (School of Nursing building on Marquam Hill campus)
  For information
  For health coaching
  To consider meds to assist with cravings or quitting
  Other

Best time(s) for appointment:
  8 am - 10 am
  10 am - 12 noon
  12 noon - 2 pm
  2 pm - 4 pm
  4 pm - 6 pm
  6 pm - 8 pm

Best day(s) for appointment:
  Monday
  Tuesday
  Wednesday
  Thursday
  Friday

  Option 2: Tobacco Medications
  To manage cravings
  To help in quitting

  Option 3: Group Support
  Online
  Group Support

  Day
  Evenings


Comments: