Thank you for visiting Trig's Pharmacy COVID-19 Vaccine Sign Up Form

If you are eligible to receive the vaccine at this time, please complete this sign up form.  If you are not eligible under the Wisconsin phased roll-out plan, please wait to take the survey until you have become eligible and you will be added to the Trig’s Pharmacy Covid-19 Vaccine Wait List at that time.  After you are added to the list and your vaccine is available you will be contacted directly by our appointment coordinator to schedule your vaccination.  Please do not call our pharmacies to check on your status.  Please understand that Trig's Pharmacy continues to vaccinate previously established priority groups before moving to new groups.   Your cooperation with this policy will help us to work as efficiently as possible and best serve our community. 

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If you identify as part of one of the eligibility groups, you may be asked to provide proof of employment or housing, etc. If you cannot provide proof, you will be asked to sign an attestation waiver to verify that you currently meet the eligibility criteria.  Please select "I understand" below:

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Preferred Pharmacy Location

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Please select which vaccine eligibility group you are in:

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