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philavax@phila.gov

215-685-6784

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Fill out both forms, then either email or fax them to us at the contact above.

Clinic registration form
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Monkeypox Provider Survey

Monkeypox Provider Survey

Monkeypox Provider Survey

The Philadelphia Health Department is looking to identify provider offices and clinics that administer monkeypox JYNNEOS vaccine to non-patients and offer walk-in hours. If you are a monkeypox vaccine provider, please fill out the brief survey.