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Quitting NOW is the single best thing you can do for your health. We can help!

DID YOU KNOW?

Of adolescents who have smoked at least 100 cigarettes in their lifetime, most of them report that they would like to quit. (source: American Lung Association)

Privacy Policy

We respect your privacy. The information collected on this form will only be used by Maryland TRASH to improve the Web site experience. We won’t sell your info.

We may occasionally contact you via e-mail to inform you of the movement’s activities. Names that are collected are not stored in the database in connection with other submitted information such as gender, age, or county. Names are only associated with contact information for submissions made to post a calendar event, an Up Close feature story, and contest entries. Information will not be disclosed to third parties. Information is collected directly and not passively through cookies.

Parents have the option to agree to the collection and use of the child’s information without consenting to the disclosure of the information to third parites. Parents have the right to review the child’s personal information, ask to have it deleted and refuse to allow any further collection or use of the child’s information.

To Parents: To provide consent to collect information on this site from your child, please print this page, provide the following information, sign and fax or mail to the fax number or address beow.

Child’s Name:

Parent Name:

Parent Signature:

Date:

Contact Information
Mailing Address
Maryland Department of Health and
Mental Hygiene
Center for Health Promotion, Education & Tobacco Use Prevention
ATT: Dana Moncrief
201 W. Preston Street
Baltimore, MD 21201
(410) 767-5316
E-mail dhmh@marylandtrash.com

or DMoncrief@dhmh.state.md.us

Please call us with any questions. To learn more about the Children’s Online Privacy Protection Rule the FTC online at www.ftc.gov/kidzprivacy.