INDEPTH-FREE Quit Vaping/Tobacco Course for Teens
Panhandle Health District offers an in-person quit tobacco and e-cigarette course throughout the five northern counties. The curriculum is designed specifically for teens and is based on the American Lung Association's INDEPTH program. It not only focuses on quitting, but also on social skills, stress management, decision making, goal setting, and physical activity. The sessions are offered once a week, for two weeks (for a total of two sessions). A certificate of completion is provided at the last class. Registration prior to the course is required.
Please Complete the form below to get registered for our next available session.
Name
*
First Name
Last Name
Student Gender at Birth
*
Female
Male
Other
Name of School Student Attends
*
Student Age
*
Primary Contact Number
*
Format: (000) 000-0000.
Who is the primary contact? (Name)
*
Student Email
*
example@example.com
Parent/Guardian Email (if under 18)
example@example.com
Register for a course
Waitlist for Hayden
Waitlist for Sandpoint
What nicotine/tobacco products does student currently use (within last 30 days)?
*
Cigarettes
Cigars
E-Cigarette/Vaping Device (e.g. Elf Bar, Puff Bar, Suorin, etc.)
Hookah
Smokeless Tobacco (e.g. chewing tobacco, snuff, dip, snus)
Other
How long has student been using tobacco products or e-cigarettes?
*
How did you hear about this course?
*
Judge/Juvenile Court Staff
Panhandle Health District Website/Facebook
Previous participant
School Administrator (i.e. Principal, Vice Principal, Dean, etc.)
School Police/Security Officer/Resource Officer
Other
If student is under 18, parent/guardian consents to student enrolling this course.
*
Yes
No
Student over 18
Parent/guardian name
First Name
Last Name
Submit
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