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JENNETS MONEYBOX VACCINE SCREENING AND CONSENT FORM Administration Facility Name/Facility ID: SECTION 1: INFORMATION ABOUT PATIENT (PLEASE PRINT) EMAIL:Name: Last: Date of Birth: Month: Day: Address:
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How to fill out miamidadefloridahealthgovprograms-andjynneos monkeypox vaccine screening

01
To fill out the Monkeypox vaccine screening form on the Miami-Dade Florida Health website, follow these steps:
02
Visit the official website of Miami-Dade Florida Health at miamidadefloridahealth.gov/programs-and-services/monkeypox-vaccine-screening.
03
Look for the Monkeypox vaccine screening form on the webpage.
04
Click on the form link to open it.
05
Review the form instructions and requirements carefully.
06
Provide accurate and complete information in the required fields.
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Double-check your entries for any errors or omissions.
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Submit the form electronically by clicking the 'Submit' or 'Send' button.
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Who needs miamidadefloridahealthgovprograms-andjynneos monkeypox vaccine screening?

01
Individuals who meet the following criteria may need to undergo the miamidadefloridahealthgovprograms-andjynneos monkeypox vaccine screening:
02
- People who have recently traveled to or lived in areas where monkeypox is known to be present.
03
- Individuals who have been in close contact with someone infected with monkeypox.
04
- Healthcare workers or laboratory personnel who handle monkeypox virus samples.
05
- Those involved in monkeypox-related research or studies.
06
- Individuals with specific medical conditions or immunocompromised individuals as determined by healthcare professionals.
07
However, it is recommended to consult with a healthcare provider or follow the guidelines provided by Miami-Dade Florida Health for accurate and up-to-date information on who needs the monkeypox vaccine screening.
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miamidadefloridahealthgovprograms-andjynneos monkeypox vaccine screening is a screening process to assess eligibility for the Jynneos monkeypox vaccine.
Individuals who are at risk of exposure to monkeypox or those in high-risk areas are required to file the screening.
The screening form can be filled out online on the miamidadefloridahealthgovprograms website or by contacting a healthcare provider.
The purpose of the screening is to determine if an individual should receive the Jynneos monkeypox vaccine for protection against the virus.
The screening form requires information about past exposure to monkeypox, current health status, and any relevant medical history.
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