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Smallpox
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Smallpox
VAERS Smallpox Pregnancy Supplement
PDF
19 Jul 12
Supplemental Form for Smallpox Vaccine in Pregnancy Registry
Smallpox Vaccine Screening Form
PDF
08 Jan 10
2-page format, STANDARD FORMAT
Smallpox Vaccine Take Check Medical Note
PDF
23 Jul 09
Follow-Up Note for Standard "Take-Check" Visits
Smallpox Vaccine Sick Call Medical Note
PDF
23 Jul 09
Follow-Up Note for Sick Call Evaluation of Patients [pre position this form at ERs and troop medical clinics]
Initial Competency Assessment: Smallpox Vaccine Administration
PDF
07 Mar 08
MILVAX Agency
Initial Competency Assessment: Smallpox Vaccine Reconstitution
PDF
07 Mar 08
MILVAX Agency
Smallpox Vaccine Screening or Medical Note Continuation Page
PDF
07 Feb 08
Smallpox Vaccination Continuation Note CHRONOLOGICAL RECORD OF MEDICAL CARE
30-day Diary Card
PDF
07 Feb 08
Symptom Diary After Smallpox Vaccination
VAERS
09 Jan 06
Vaccine Adverse Event Reporting System