Smallpox/mpox Immunization Consent Form
Coherent Identifier 20.500.12592/bhhtxw

Smallpox/mpox Immunization Consent Form

3 March 2023


Benzonase is used for purification of viral vaccines, viral vectors for vaccine, cell and gene therapy, and oncolytic viruses, removing DNA/RNA from proteins and other biologicals; reduction of viscosity caused by nucleic acids; sample preparation in electrophoresis and chromatography and prevention of cell clumping 3. [...] This form can be printed as a paper copy Smallpox/mpox Immunization Consent Form I have read (or it has been read to me) and I understand the information provided on Smallpox/mpox vaccine. [...] I have had the opportunity to ask questions and to have them answered to my satisfaction. [...] I have had the opportunity to speak with a healthcare worker regarding any special consideration that apply to me in respect to the vaccine for Smallpox/mpox. [...] 29 and s.34(a)(m) of the Personal Health Information Act, and will be used for determining eligibility to receive COVID-19 immunization and monitor organizational uptake of the COVID-19 vaccine.

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