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To obtain reimbursement (up to $50.00) for attending a
smoking cessation class, call HNE to obtain a log number,
fill out this form, cut along the dotted line and bring it to
class with you. Mail the completed form to:
Your Member ID Number:
Your Log Number:
413-787-4000 or 800-842-4464
HNE is behind you in your efforts to become and
remain smoke free. In fact, we believe so strongly that quitting smoking will improve your quality of life and
overall health that, we will pay up to $50.00 for you to attend a smoking cessation class. This offer is available
Class Dates and Location:
to HNE members who have diabetes, asthma, high
cholesterol, coronary heart disease, and/or are pregnant.
Many smoking cessation programs recommend the use
of nicotine replacement therapies (NRT or Zyban®) to supplement and support your efforts. Your doctor
(obstetrician if you are pregnant) should decide if these are safe options for you. Depending on your Health
New England insurance policy, if you are enrolled in a
smoking cessation program, you may be eligible to get
these medications for a limited time for a copay. (Individual coverage/copays vary by employer group).
Check with your Benefits Administrator for possible coverage of the following:
Nicotrol® nasal sprayNicotrol® inhalerZyban®Chantix®
HNE USE ONLY:
(Note: These medications, if covered,
Effective Date: ___________________________
Group #: _______________________________
of doses per prescription and refills
Paid Date: ______________________________
per calendar year. Call HNE forupdated information.)
Check # ________________________________
For HNE members with diabetes, asthma, high cholesterol, coronary heart disease, pregnancy
Health New England Smoking Cessation Program Voucher •ENCLOSED• hne.com
Baystate Medical Center, Springfield, MA
"Freedom from Smoking" (run by the Pulmonary Rehab Dept.) 413-794-2255, The Professionals
Cooley Dickinson Hospital, Northampton, MA 413-582-2649 or 413-582-2400, Sue Lesser, RN
Baystate Franklin Medical Center, Greenfield, MA 413-773-2454, Rose Deskavich, OTR
Berkshire Medical Center, Pittsfield, MA 413-499-2602, Carol McMahon, MS
Lung Disease Help Line
American Lung Association of Western, MA
(staffed by Nurses, Respiratory Therapists, Smoking Cessation Specialist) lungusa.org
Noble Hospital, Westfield, MA
"Freedom from Smoking" (run by the Respiratory Therapy Dept.) 413-568-2811, Ext. 5731
Try-To-Stop Tobacco Resource Center of Massachusetts 800-trytostop (800-879-8678)
P.S. Will consider reimbursement for hypnosis programs up to $50 ONLY.
ILLINOIS STATE UNIVERSITY Organic Chemistry 1, CHE 230, fall semester 2010, Homework #2 Chapter 2: Structure and Reactivity Write out the dissociation expression for acetic acid (CH3CO2H). Write out the K a expression for the above equilibrium. Provide a rationale for why acetic acid (CH3CO2H) is more acidic than ethanol (CH3CH2OH). © 2010 Assoc. Prof. S. R. Hitchcock, Departme
Presentation Contra-Indications, Warnings etc. Fortekor 2.5: For animal treatment only. For oral use only. Wash handsPalatable beige, ovaloid tablets which are scored on bothIn man, the combination of ACE inhibitors and NSAIDS2.5 mg benazepril hydrochloride (Fortekor® 2.5). can lead to reduced antihypertensive efficacy or impaired Fortekor 5 and 20: renal function. Therefore c