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Monroe, Trempealeau counties offer COVID vaccine interest and screening forms

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SPARTA, Wis. (WXOW) - Based on increased calls by residents wanting vaccinations, both Monroe and Trempealeau counties are rolling out COVID-19 Vaccine Interest Forms.

The form for Trempealeau County, which can be found here, is already available to residents.

The Trempealeau County Health Department asks that eligible people interested in getting the vaccine complete the form. A statement said that if you've already talked to someone in the department, you don't need to fill out the form.

The department said that by late next week, they'll have a version of the form available in Spanish.

By filling out the form, the health department said it automatically connects those eligible for the vaccine with a vaccine provider, who will then reach out to make an appointment. The health department cautions that it may take some time before a provider contacts you for an appointment.

The statement said the following groups are currently eligible for the vaccine: health care personnel in phase 1A, police, fire, and correctional personnel, coroners/medical examiners, funeral personnel, and people age 65 or older.

The form for Monroe County is available starting Monday, January 25. Information on vaccinations for people in Monroe County can be found here.

The Monroe County Health Department provides additional ways for people who aren't able to complete the form or do not have access to a computer or internet.

The first is by sending an email to

For those who don't have computer/internet access, they can call the Monroe County Health Department at 608-269-8666 and press 3.

Similar to Trempealeau County, the form connects individuals to vaccinator providers who will schedule an appointment when the vaccine is available.

The list of those eligible is also the same.

The health department said the form only needs to be filled out once. They emphasized that signing up multiple times does not improve your chances of receiving the vaccine sooner.

They also said that those who aren't eligible for the vaccine yet should fill out the form. Once eligible, a provider will contact individuals. The health department cautioned that it could be several months until that happens.

RELATED: Everyone over 65 next in line for vaccine in Wisconsin; Find the La Crosse County screening form here

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