The code block below illustrates how one might use # and // as comments in your logic and calculations.

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The value entered is not a valid Vanderbilt Medical Record Number (i.e. 4- to 9-digit number, excluding leading zeros). Please try again.

The value you provided must be within the suggested range

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This value is admissible, but you may wish to double check it.

The value entered must be a time value in the following format HH:MM within the range 00:00-23:59 (e.g., 04:32 or 23:19).

This field must be a 5 or 9 digit U.S. ZIP Code (like 94043). Please re-enter it now.

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Required format:

87conGt2Y8egsvqgjdZHrI572dmZ99Tcx3INjD3PxtxNR

Center For Tobacco-Free Finger Lakes Training

Funded by the NY State Department of Health, all Train-the-Trainer support for your healthcare system and clinics is provided free of charge by the Center for a Tobacco-Free Finger Lakes, serving medical healthcare systems and mental healthcare systems in Monroe, Seneca, Ontario, Wayne Livingston, Schuyler, Chemung, Yates, Steuben counties. Train-the-Trainer content for your system's Tobacco Dependence Treatment includes: policies, treatment workflows, ongoing curriculum materials to choose from for your clinicians, and help with internal quality assurance metrics).

Please respond to the following brief questionnaire. This is not a committment to training, but it allows us to get information about your setting and address any questions.

Thank you for your time!

YOUR CONTACT INFO: Please provide your name and contact information (phone and/or email) so we may follow-up with you for training and/or to answer any questions.

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Is your setting Medical Health, Mental Health, or both?

Medical Health

Mental Health

Both

Not Applicable

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Please select the answer that best describes your current position.

If other, what is your current position?

Never

Sometimes

Always

Don't know

N/A

. . .provide counseling and support for patients/clients ready to quit using tobacco?

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. . .refer to NYS Smokers' Quitline and/or local cessation programs?

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. . .provide clinician training in tobacco dependence treatment?

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. . .provide assessment and feedback regarding clinical interventions with tobacco dependent patients?

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Would you like to set up a train-the-trainer session with your key clinicians and/or staff?
(Typically between 15 and 60 minutes, based on your setting / convenience)

Yes

No (or Not Sure At This Time)

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If yes for a training or to discuss further (no commitment), when would be a good time-frame for you?

Within the next 30 days

Within the next 3 months

Within the next year

Unsure, but we can discuss further

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Do you have any questions or comments for us?

Thank you for your time!

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