Request a Call from Quitline for Free Quit Support

1. Your details

First name *

Last name *

Preferred contact number *

Postcode *

Email (optional)

We'll do our best to call at your chosen call times.

Preferred call date *

Preferred call time (Weekdays) *

8am - 12pm

12pm - 4pm

4pm - 7pm

Any time is fine

Preferred call time (Saturdays) *

9am - 12pm

12pm - 4pm

You miss our call, do you give permission for the counsellor to leave a voicemail? *

Yes

No

Do you require an interpreter? *

Yes

No

Which language? *

Would you like to speak to an Aboriginal counsellor?

Yes

No

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