Student Immunization Clinic Registration
Thank you for registering your child for an upcoming FREE K-12 student immunization clinic in The School District of University City.

The 2023 free student immunizations clinics are scheduled for Saturday, April 15, and Friday, August 18, from 9 to 11 a.m. at the McNair Administration Building, located at 7700 Olive Blvd. (63130). Please specific your preferred clinic date, time frame and immunizations needed (see flyer below for State Regulations regarding immunizations. (Be prepared to upload PDF/JPG of immunization record if you need assistance in deciding which immunization(s) to request.)

Consent forms are required. Please click on the appropriate form below, download to your computer and open the PDF file to complete and save the form. Then email with your child's immunization records to your school nurse. 

If you have questions as to which immunization(s) your currently-enrolled child needs, please contact their school nurse directly.
- Barbara C. Jordan Elementary - Ramona Symonette at
- Flynn Park Elementary - Cherich Jones at / Tamara Bartley at
- Jackson Park Elementary - Johnnye Farrell at
- Pershing Elementary - Patricia Chandler at
- Brittany Woods Middle - Cristin Latimore at
- University City High School/LLC - Kendress Hughes at

For more information about state-required immunizations, visit
For all other questions, please contact District Lead Nurse Pat Wilson at

Please submit a separate registration for each student needing immunizations. Upon submission, please watch for an email from "Google Forms" with a copy of this registration for your personal use.

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Email *
Parent/Guardian/Caregiver Full Name *
Best Email *
Best Daytime Phone *
Student's First Name *
Student's Last Name *
Clinic Choice *
Grade level for the fall *
School *
Please choose your child's school. NOTE abbreviations: BCJ=Barbara C. Jordan Elementary School, FP=Flynn Park Elementary School, JP=Jackson Park Elementary School, Pershing Elementary School, BWMS=Brittany Woods Middle School, UCHS=University City High School, LLC=Lieberman Learning Center, AEL=Adult Education and Literacy Program
Immunization(s) needed *
Consent Forms & Immunization Records *
The following have been sent via email or personally delivered to my child's school nurse:
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