We want to hear from you!

Please provide your feedback about the Hamilton Cessation Portal for quitting smoking and enter for a chance to win a $100 grocery gift card. It will take less than a minute!

* 1. Reason for visiting the Hamilton Cessation Portal?

* 2. How did you hear about the Portal (check all that apply)?

* 3. How do you describe yourself?

* 4. How old are you (enter number):

* 5. If you would like to enter into a draw for a chance to win a $100 grocery gift certificate, please include your email address or phone number:

* 6. In the future, we plan to evaluate this site and the smoking cessation services it refers visitors to. We would be interested in hearing your views and providing you with another chance to win a prize.