Nicotrax Logo Horizontal

PERSONAL INFO

YOUR HEALTH

SMOKING BEHAVIOR

COVERAGE

COMMITMENT

PERSONAL INFO

Let's start with the basics.

Don’t worry, you can always update this down the road.

The agreements below govern your access to and use of the Nicotrax program. Please review them carefully to learn how your personal information may be used and disclosed.

I have read and agree to the Nicotrax Terms of Use and Privacy Policy.

I have read and agree to the terms of the Nicotrax HIPAA Notice (applicable to U.S. residents only) and Consent to Share and Release Information.

If you have any questions regarding these documents or participation in the Nicotrax program, please contact us at support@nicotrax.com.

Do you have questions?