Snohomish County TPOXX IND Enrollment and Treatment Request Form
Thank you for your interest in providing TPOXX. This form is for healthcare providers in Snohomish County. If you are not a healthcare provider and/or if you are not located in Snohomish County, please do not complete this form. If you are a healthcare provider in another county, please contact your local health jurisdiction.
For Snohomish County healthcare providers, please fill out this form to the best of your ability and we will reach out to you regarding next steps.