*1.Full Name(Required.)

*2.Email Address(Required.)

*3.Phone Number(Required.)

*4.Would you consider yourself part of any of the following groups?(Required.)

Individuals at high risk of occupational exposure to monkeypox (e.g., clinical lab personnel performing diagnostic testing for monkeypox).

Individuals identified as having exposure to monkeypox virus during case investigation and contact tracing activities.

Individuals with attendance at events/venues linked to known monkeypox transmission.

Any individual who has or is likely to have prolonged intimate contact that would put them at higher risk of being exposed to monkeypox virus (e.g., men, transgender women or men, or non-binary persons who have or plan to have sexual encounters with men and have risk factors, such as: history of multiple or anonymous sex partners, participation in group sex, attendance at sex-on-premise venues or events, sex work).

Nationally or locally identified groups with high risk of exposure.

No, none of the above. 

5.What type of information would you like to receive?

Mpox (Jynneos) Vaccination Opportunities in Butler County

1:1 Education on Mpox - Prevention, Vaccination, etc.

General Mpox Information - Prevention, Vaccination, etc.