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Forms & Instructions for Filing a Claim
To
apply for benefits you must submit a complete
Request Package within the period described
in the regulations:
- A
Request Form concerning an injured smallpox
vaccine recipient must be postmarked within
1 year of his or her receiving a smallpox
vaccination under a Plan.
- A
Request Form concerning an injured vaccinia
contact must be postmarked within 2 years
of the date of the onset of his or her medical
injury.
Forms
& Instructions
Contact:
smallpox@hrsa.gov
or 1-888-496-0338
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