Click on each question to expand/collapse the full conversation
Are you ready to get started?
yes
What's your first name? You can spell it if you like.
cece
Just to confirm, your first name is c, e, c, e ; one word. Is that correct?
yes
What's your last name? You can spell it if you like.
herbert
Just to confirm, your last name is h, e, r, b, e, r, t ; one word. Is that correct?
yes
What's your date of birth?
15th march 94
What's your phone number?
3333333333
What's your email address? This will become your login.
chchch"gmail.com
Sorry, I didn't catch that clearly. Please say your email address again. It will become your login.
chcch@gmail.com
Just to confirm, your email address is c, h, c, c, h, at, g, m, a, i, l, dot, c, o, m. Is that correct?
yes
What's your address?
144 Florida street, Florida
Thank you. To complete your address, could you please provide the city, state, and ZIP code?
5528 Citrus Hill Dr, Polk City, FL 33868, USA
Please tell me about your current health insurance. I'll read a list of options, and you can tell me which one describes your situation. a. Uninsured; b. Both Medicaid and Medicare (Dual Covered); c. Medicaid; d. Medicare; e. Military Insurance (TRICARE); f. Prefer not to say; g. Private/Commercial/Employer-Based; h. Other (a health plan that is not Medicaid or Medicare); i. I don't know.
i
To help you become tobacco-free, we can connect you with a live coach by phone, text, or chat. You can also choose our online program if you prefer using our digital tools. Which option sounds better for you — phone or online?
online