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{* loginWidget *}

OR

{* #userInformationForm *} {* traditionalSignIn_emailAddress *} {* traditionalSignIn_password *}

By registering, you agree to receive additional communications regarding product information, promotions, newsletters and surveys from our site. If you choose to register with a social provider, certain information will be shared by your social provider with our site.

{* traditionalSignIn_signInButton *}{* traditionalSignIn_createButton *}

{* /userInformationForm *}

Sign In

Welcome back, {* welcomeName *}!

{* loginWidget *}

Use another account

Sign In

Welcome back!

{* #userInformationForm *} {* traditionalSignIn_emailAddress *} {* traditionalSignIn_password *}

{* traditionalSignIn_signInButton *}

{* /userInformationForm *}

Use another account

Almost Done!

Please confirm the information below before signing in.

{* #socialRegistrationForm *} {* socialRegistration_firstName *} {* socialRegistration_lastName *} {* socialRegistration_emailAddress *} {* socialRegistration_displayName *} {* socialRegistration_gender *} {* socialRegistration_birthdate *} {* socialRegistration_address *} {* socialRegistration_unit *} {* socialRegistration_zipcode *} {* socialRegistration_addressType *} By submitting your information above, you agree that the information you provide will be governed by our site's Privacy Policy.

{* backButton *}

{* socialRegistration_signInButton *}

{* /socialRegistrationForm *}

{* #registrationForm *}

First, tell us a bit about yourself.

Your personal information will be governed by our Privacy Policy.

* REQUIRED FIELD

{* languageCode *}

How do you prefer to be addressed?

{* traditionalRegistration_title *} {* traditionalRegistration_firstName *} {* traditionalRegistration_lastName *}

How can we reach you?

{* traditionalRegistration_address *}

{* traditionalRegistration_unit *} {* traditionalRegistration_city *} {* traditionalRegistration_state *} {* traditionalRegistration_zipcode *}

{* traditionalRegistration_emailAddress *}

{* traditionalRegistration_emailAddressVerify *}

Almost finished! Please tell us a bit about your practice.

This will help us understand your needs so we can send the right resources.

What is your profession?*

{* specialty *}

What is your practice setting?*

{* practice_setting *}

How many client conversations around smoking cessation do you have per week?

{* traditionalRegistration_clients_in_week_radio *}

When recommending or prescribing NRT, which approach do you most frequently use?

{* traditionalRegistration_prescribing_approach *} {* traditionalRegistration_presc_appr_other *}

How many professional staff work in your practice?

{* traditionalRegistration_professionals_in_practice *}

How comfortable are you with smoking cessation counselling?

(eg. 1=not very comfortable, 5=very comfortable)

{* traditionalRegistration_comfort_counselling *}

What is your main reason for joining the HelpThemQuit program?

Please select all that apply.

To Get Counselling Tips and Techniques

To Receive Product News & Updates

To Receive Samples/Coupons

To Receive Support Tools & Resources

To Learn More About Smoking Cessation Treatment

{* traditionalRegistration_reason_to_join_chkbx *}

How did you hear about us?

{* traditionalRegistration_how_you_heard *}

Lastly, please create a password.

This allows you to log in to the website, and adjust your preferences, contact information and more.

{* traditionalRegistration_password *} {* traditionalRegistration_passwordConfirm *}

{* Agreement *}

Your personal information will be stored in the databases of Johnson & Johnson Inc. and its third-party service providers inside and outside Canada. The personnel, agents and third-party service providers of Johnson & Johnson Inc. may have access to your personal information to manage data in compliance with our Privacy Policy (available at https://www.helpthemquit.ca/privacy-policy) or to provide you with promotional materials or services you have requested or to which you have consented. For more information on the privacy practices of Johnson & Johnson Inc., including data collection, use, purposes, disclosure and our use of service providers inside and outside of Canada, or to request a written copy of our Privacy Policy, access to your file or the correction of information, or to unsubscribe or withdraw your consent for any communications from us, please use our Contact use form (available at https://www.helpthemquit.ca/contact-us) or send your request by mail to Johnson & Johnson Inc. Consumer Care Center, Attn: Canadian Chief Privacy Officer, 199 Grandview Rd., Skillman, NJ, USA 08558-9418.

{* createAccountButton *}

{* /registrationForm *}

We are missing some information in your account.

{* #requirementsPostLoginForm *} {* firstName *} {* lastName *} {* gender *} {* birthdate *} {* address *} {* zipcode *} {* addressType *}

By submitting your information above, you agree that the information you provide will be governed by our site's Privacy Policy.

{* saveButton *} {* /requirementsPostLoginForm *}

Create a new password

We'll send you a link to create a new password. test

{* #forgotPasswordForm *} {* traditionalSignIn_emailAddress *}

{* backButton *}

{* forgotPassword_sendButton *}

{* /forgotPasswordForm *}

Create a new password

Looks like you have an existing account with us. We have made some changes to our site and we need you to create a new password in order to login. Click send to recieve an email with instructions on how to create your new password.

{* #optinUserNewPasswordForm *} {* optinUser_emailAddress *}

{* backButton *}

{* forgotPassword_sendButton *}

{* /optinUserNewPasswordForm *}

Create a new password

We've sent an email with instructions to create a new password. Your existing password has not been changed.

{* mergeAccounts *}

Sign in to complete account merge

{* #tradAuthenticateMergeForm *} {* traditionalSignIn_emailAddress *} {* mergePassword *}

{* backButton *}

{* traditionalSignIn_signInButton *}

{* /tradAuthenticateMergeForm *}

Updated Privacy Policy

{* #privacyPolicyPostLoginForm *}

By clicking Accept below, you confirm that you have read, understand and accept our most recent Privacy Policy.

{* privacyPolicyAcceptButton *}

{* /privacyPolicyPostLoginForm *}

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Welcome back!

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Please confirm the information below before signing in.

First, tell us a bit about yourself.

Almost finished! Please tell us a bit about your practice.

Lastly, please create a password.

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