URMC / Center for Community Health & Prevention / Patient Care / Stop Smoking/Vaping / Commit to Quit! Group Program / Register Now Register Now Please Note: Registration closes 24 hours prior to each session. First Name: Last Name: Email Address: Select the Session(s) You Would Like to Attend (Select as Many as You Like): Session 1: Find Your Why (September 14, 2023, 5-6 p.m.)Session 2: Breaking the Chain (September 21, 2023, 5-6 p.m.)Session 3: Exploring Quit Aids (September 28, 2023, 5-6 p.m.)Session 4: Engage Your Support System (October 5, 2023, 5-6 p.m.)Session 5: Stress as a Trigger (October 12, 2023, 5-6 p.m.)Session 6: Staying the Course (October 19, 2023, 5-6 p.m.) At this time, how confident are you in your ability to quit using tobacco/vapes/nicotine?: 1 - No Confidence23 - Neutral45 - Very Confident Gender: MaleFemaleTransgenderDo Not Identify As Male, Female, or TransgenderDecline to Answer Age: Race (Select All That Apply): American Indian/Alaska NativeAsianNative Hawaiian or Other Pacific IslanderBlack or African AmericanWhiteDecline to Answer Ethnicity: Hispanic or LatinoNOT Hispanic or LatinoDecline to Answer County of Residence: Select one... Allegany Chemung Genesee Herkimer Livingston Monroe Ontario Orleans Oswego Schuyler Seneca Steuben Wayne Wyoming Yates Other Please Specify Other County: State of Residence (in XX format): How did you hear about the program: I understand that participation in the Commit to Quit! program is confidential and agree to contribute to the supportive, non-judgmental environment of the program.