COVID-19 Vaccination Clinic Pre-Registration
Waiting List for the Upcoming Clinics
Vaccine is only available for the following priority groups right now. Please select the group you are in.
Healthcare, Police/Fire, Correctional Staff
Age 65 years or older
K-12 Staff (Contact with Students)
Individuals Enrolled in Medicaid Long-Term Care Program (IRIS, Family Care, Katie Beckett)
Utility, Communication, Public Transit Workers
I do not fit into the groups above. (At this time we are not able to vaccinate individuals outside of these groups. Please do not register at this time.)
Are you a Crawford County resident? (At this time, only Crawford County residents are prioritized )
If K-12 Staff, what school do you work at?
Please choose all locations you are willing to attend.
Prairie du Chien
If you would like your scheduled time to be the same day and time as someone else, please list the name of the other person below.
Street Address Line 2
State / Province
Postal / Zip Code
Date of Birth
American Indian or Alaska Nativ
Native Hawaiian or Other Pacific Islander
Please enter a valid phone number.
Second Phone Number
Have you ever had an observed anaphylactic reaction? If so, was it to a component of the COVID-19 vaccine, another vaccine, or an injectable (e.g., instramuscular, intravenous, or subcutaneous) therapy?
If yes, please list:
Have you received antibody therapy or convalescent plasma for COVID treatment in the past 90 days?
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