Quitpath (Plus) Program Registration - Smoking Cessation Programs

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Registration

To register or to find out more about Health Promotion's free smoking cessation programs, call 667-8393 or toll-free 1-866-221-8393 or email us at info@quitpath.ca.

Available to Yukon residents only

All fields are required
First Name:
Last Name:
Age Range:
Street Address:
Apt. Number (if applicable)
City/Town:
Territory: (Yukon only)
Postal Code:
Telephone Number:
Email Address:
Which Session would you like to attend

We will protect your privacy when you sign up.

The personal information below will remain secure, and your name and contact information will not be sold or otherwise used for any other purpose. The information that will be gathered during telephone calls will only be used to help us evaluate the QuitPacth program.