Moultrie County Health Department
Moultrie County Health Department
  • 202 South Main, Sullivan, IL 61951
  • 217-728-4114
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Moultrie County COVID-19 Vaccination Information

Moultrie County COVID-19 Vaccine Waiting List

If you live or work in Moultrie County and meet Phase 1A or Phase 1B criteria, you may sign up for the Moultrie County COVID-19 Vaccine Waiting List using the online form (below). You are also welcome to sign-up by phone (217-728-4114) or in-person at the Moultrie County Health Department (MCHD) in Sullivan, Illinois.

As with all county health departments, the MCHD currently receives a limited number of COVID-19 vaccine doses each week.  Presently, local demand for the vaccine exceeds supply.

Our goal is to efficiently and fairly serve everyone who qualifies for a COVID-19 vaccine in Moultrie County. To achieve this goal, the MCHD will:

  1. Verify COVID-19 vaccine availability before scheduling appointments for vaccinations,
  2. Contact individuals by phone from the Moultrie County COVID-19 Vaccine Waiting List in order of sign-up (whether online, by phone call, or in-person), and
  3. Schedule these qualified county residents and employees for first and second vaccine appointments.

If you have any concerns regarding whether or not you should consider the Covid-19 vaccination, please contact your healthcare provider.  If you have any questions about the vaccine or the process for registering for the Moultrie County Covid-19 Vaccine Waiting List, please contact the Moultrie County Health Department at 217-728-4114.  Office hours are Monday – Friday, 8:30a – 12:00p and 1:00p – 4:30p.

Please Read the Following Instructions Before Completing the Form Below

1. You must fill out ONE form for each person requesting a COVID-19 vaccination.

PLEASE do not submit more than one person’s name on the form.

2. You must provide an accurate Phone Number.

The Moultrie County Health Department (MCHD) will contact you BY PHONE ONLY when your appointment becomes available.

3. Please do not submit more than one form for the same individual.

Multiple submissions or phone calls do not increase your opportunity for a COVID-19 vaccination appointment.

4. The MCHD will contact all Individuals who submit this form for a COVID-19 vaccine appointment in the order their request was received when doses become available.

5. If you previously submitted your name by phone to the MCHD and would like to submit this online form, please complete & submit the form only ONCE.

If possible, please identify the date you previously submitted your name by phone in the NOTES section.

6. Please provide an email address in the space provided so that the MCHD can send you confirmation of your submitted form.

A confirmation only means that the electronic system received your form. It does not confirm a vaccine appointment. The MCHD will schedule your vaccine appointment by phone.

7. If there are special considerations or other things you would like for us to know, please briefly state those concerns in the form’s NOTES section.

8. Every person who arrives for a vaccine will be required to provide proof of identity (driver’s license) and residency or work status in Moultrie County, Illinois.

Sign-up for Covid19 Vaccination Waiting List

Step 1 of 3

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  • We’re sorry but you do not qualify for a Covid-19 vaccination at the Moultrie County Health Department.

    Please contact the health department where you reside for information on how to obtain a Covid-19 vaccination.
  • Please continue with the Moultrie County Covid-19 Vaccine Waiting List form by selecting the "Next" button below.
  • I am in one or more of the following Priority Groups eligible in Illinois for my Covid-19 Vaccination when it becomes available.

    Please check all that apply:
  • Please continue with the Moultrie County Covid-19 Vaccine Waiting List form by selecting the "Next" button below.
  • Please include your E-mail address if you would like confirmation that your Waiting List Form has been received. This is NOT a confirmation of an appointment. We will contact you BY PHONE for your appointment.
  • I agree to have representatives of the Moultrie County Health Dept contact me by phone at the number I have listed above to make arrangements for me to receive a COVID-19 vaccine at the Moultrie County Health Department.
    *
  • I attest under the penalties of perjury to the best of my knowledge and belief that I belong to the priority group(s) that I selected above and that I live, work, or study in Moultrie County. I understand I may be asked for identification (e.g. employer issued ID card, government issued identification or license, paystub).
    *
  • Please briefly state anything else we should know about you or your appointment request (such as difficulty with walking, scheduling preferences, etc.) We will do our best to accommodate special considerations when scheduling your appointment.

Moultrie County Health Department

Address:
202 S Main St.

Sullivan, IL 61951

Phone:
217-728-4114

Hours:
Monday-Friday, 8:30 a.m. – 12:00 p.m. and 1:00 p.m. – 4:30 p.m.

The Moultrie County Health Department is an equal opportunity provider. Read the complete policy.

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Adult Health Services
Children’s Health Services
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Environmental Health Services
Maternal Child Health Services

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Moultrie County Health Department
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  • 202 South Main, Sullivan, IL 61951
  • 217-728-4114