Flu Vaccinations – Step 1


    I am a gay male, a bisexual male, or a male that has sex with other malesI have had a sexual partner in the past 14 days who has received a monkeypox diagnosis OR I have had multiple sexual partners in the past 14 days in a jurisdiction with known monkeypoxI am 18 years of age or olderI currently do NOT have signs or symptoms consistent with a monkeypox infection (fever; headache; muscle ache; backache; swollen lymph nodes; chills; exhaustion; or a rash / blisters on my face, inside of my mouth, or on other parts of my body including hands, feet, chest, genitals, or anus)I do NOT have a severe allergy to egg proteins, benzonase, gentamicin, or ciprofloxacin

    Please read the HIPAA Notice of Privacy Policy
    Received the Gwinnett, Newton, and Rockdale HIPAA NOTICE of Privacy Policy

    Please read the JYNNEOS Vaccine Information Statement
    I read and understand the above JYNNEOS Vaccine Information Statement and understand the benefits and risks of the Jynneos Monkeypox vaccine.

    I agree to remain onsite for 15 / 30 minutes after the vaccine is administered to be monitored for adverse reactions.

    Full Name:

    All check boxes must be checked to be eligible to request an appointment. If the answer to any question is "no", you are ineligible to receive the monkeypox vaccine.