In this retrospective observational analysis, investigators sought to compare mpox evaluation patterns across different care settings in a single academic health system.  Primary composite outcome was documented elements of CDC recommendations: (a) anogenital exam, (b) sexual history, and (c) comprehensive STI testing (gonorrhea and chlamydia, syphilis, and/or HIV screening).  276 patients with mpox testing or treatment were included for analysis: mean age was 41.2 years, 66.3% were male at birth, and 23.9% were living with HIV.  50.7% identified as heterosexual, 29.7% gay, and 7.2% bisexual.  Over one-third were privately insured (37.3%) or covered by Medicaid (35.9%). 62.7% were evaluated in emergency departments, 18.8% in primary care clinics (this included adult internal medicine, pediatrics, OB-GYN, dermatology or other ambulatory care), and 18.5% in an infectious disease/sexual health clinic.  26.4% of mpox tests performed were positive, with highest positivity in the ID/sexual health setting (51.0%). Sexual history was documented in 98.0% of ID/sexual health encounters compared to 80.8% of primary care and 68.8% of emergency department encounters (p < 0.001). Anogenital exam frequency also differed: 82.4% (ID/sexual health), 40.4% (primary care), and 44.5% (emergency department) (p < 0.001).  Comprehensive STI testing was performed in 80.4% of ID/sexual health visits compared to 38.5% and 53.8% of primary care and emergency department visits, respectively (p < 0.001). Among patients with positive mpox testing, STI coinfection prevalence was 20.4% (syphilis was most common). Cisgender MSM and transgender persons (as a group) had greater odds of completing the composite outcome (aOR 4.03) compared to cisgender females.