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Adult Tobacco Quit Kit Request
Questions marked with a * are required
Congratulations! You're on the road to being tobacco-free. To request an adult tobacco quit kit, please fill out the information below. For questions, please call the Tobacco Prevention Program at 754-6460. You must live in Calaveras County.
Contact Information
Mailing Address:
City/Town
Zip Code (Please enter your 5 digit postal code):
Age:
Gender:
Do you currently use tobacco? (cigarettes, cigars, electronic cigarettes/vapes, etc):