San Juan USD Immunization Clinic Appointment
The SJUSD Immunization Clinic is located at San Juan Central Enrollment Room #4 (3700 Garfield Ave, Carmichael, CA, 95608). The clinic is supported by Vaccines for Children (VFC) and adheres to their program requirements. The clinic is only open to individuals 18 years of age and younger who do not have health insurance, are underinsured, are Medicaid eligible or are American Indian or Alaskan Native. Clinic days and hours are limited. One appointment per child is required. Please plan to arrive 10 minutes prior to your scheduled appointment time to begin completing required paperwork. (If no times are available on your requested date, please choose another open date in the future). A $10/child voluntary administrative fee is requested per appointment (cash only).
Appointment
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Student Name
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First Name
Last Name
Student Date of Birth
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-
Month
-
Day
Year
Date
Student Gender
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Please Select
Female
Male
Gender-neutral
Decline to state
Student Ethnicity
*
Please Select
American Indian or Alaskan Native
Asian or Pacific Islander
Black or African American
Hispanic or Latino
White
Other
School of Attendance for the 2023-24 school year (if known)
Student Grade for the 2023-24 school year
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Parent/Guardian Name
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First Name
Last Name
Parent/Guardian Email
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example@example.com
Phone Number
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Please enter a valid phone number.
Family's preferred language:
If not English, would you like an interpreter at the appointment?
Yes
No
Not Applicable
Do you have a copy of your child's immunization records?
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Yes
No
If yes, please upload an electronic copy or screenshot(s) of your child's immunization records below. This will save time at your appointment. Please also make sure to bring a copy with you to your child's appointment. Forms should be in English (or translated to English prior to appointment).
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By signing here, at the time of making this appointment, I confirm that my child does not have health insurance
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