Quit Partner (a program of the Minnesota Department of Health) is asking you to provide the information on this form to collect Quit Tips it can use to inform the public about tools and support to quit commercial tobacco and to inspire others to quit smoking.
You are not legally required to submit any of the requested information and can refuse to do so. The only consequence of not supplying the information is that Quit Partner will not be able to share your Quit Tip. You do not have to submit a story or any of the information requested on this form to receive Quit Partner services.
The Quit Tip (or a portion of it) and first name you submit may be made publicly available in Quit Partner publications or presentations, which may be made available online or shared with mass media outlets or local public health partners.
Quit Partner will not share your email address with persons other than those listed below, but may use your email address to contact you for more information.
The information you submit may also be released as follows:
- To employees of the Minnesota Department of Health (MDH) or MDH’s Quit Partner media contractor whose work reasonably requires access to the data;
- As required by a Court Order;
- To any person or entity you authorize to receive the data;
- To any other person authorized by state or federal law to receive the data.
