Missouri is one of the few states that requires both immunization documentation and a comprehensive physical exam for school entry. Here is every form you need, where to get it, and how to meet both requirements before the first day of school.
Last verified: September 8, 2026
Under RSMo §167.181, every child enrolling in a Missouri school must provide a Certification of Immunization from the Missouri Department of Health and Senior Services (DHSS). This form, completed by a licensed physician or authorized health department provider, certifies that all required immunizations have been received or that a qualifying exemption applies.
Required vaccines for K–12 school entry in Missouri:
Missouri is one of a small number of states with a mandatory physical exam requirement for school enrollment. Per RSMo §167.181, students entering Missouri schools for the first time must provide documentation of a physical examination conducted within the 12 months prior to school entry.
The physical exam must be performed by a licensed physician, physician assistant, or advanced practice registered nurse. The Missouri DHSS provides a standard physical exam form, though many physicians use their own forms that meet the same documentation requirements. The completed form must be submitted to the school along with the immunization certification.
What the physical exam covers: Height, weight, vision, hearing, blood pressure, and a general physical assessment. The examining provider certifies the child is free of communicable disease and physically able to participate in school activities.
Most states require immunization records but not a physical exam for initial school enrollment. Missouri's dual requirement — the Certification of Immunization and the physical exam form — is what catches many families off guard, particularly those relocating from other states or from home schooling environments.
The practical impact: you need two separate physician-signed documents before the first day of school. The physical exam must be from the prior 12 months, and the immunization certification must reflect current, complete doses. Both documents need to be submitted to the school health office before enrollment is finalized.
Missouri's ShowMeVax registry is your fastest way to confirm which doses are already on file. Contact your local health department to request a ShowMeVax print-out, then schedule the physician visit knowing exactly which doses (if any) still need to be given alongside the physical exam.
Contact your local health department for a ShowMeVax immunization history. Download the Missouri physical exam form from DHSS or ask your pediatrician for their form. Book the physician visit early — this is peak season for school physicals in July and August.
Missouri's physical exam and immunization certification can be completed at the same appointment. Ask your physician to bring both forms to the visit and confirm all required vaccines and the physical exam documentation are completed together.
Missouri law requires both the immunization certification and physical exam on file before enrollment. A grace period of up to 30 days may be available — contact your school's health office if there are extenuating circumstances.
Missouri school health offices retain the originals. Keep a copy — the physical exam form and immunization history are frequently needed for sports physicals, camp enrollment, and future school transfers within Missouri.
Missouri's dual-form requirement means two physician-signed documents sitting in two different places — the school's file and hopefully yours. Family Stork makes sure yours is complete and organized.
Give any Missouri clinic your child's private @families.familystork.com address. They send visit summaries, physical exam results, and immunization records — the health timeline builds itself. When the next school year opens enrollment, everything is already filed and ready.
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Missouri recognizes medical and religious exemptions from school immunization requirements under RSMo §167.181. Medical exemptions require a written statement from a licensed physician. Religious exemptions require a written and signed statement from the parent or guardian citing religious beliefs. Note: the physical exam requirement has a separate exemption process — contact your school or DHSS for details.
For exemption forms and the official process, contact the Missouri Department of Health and Senior Services — Immunization Program.
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Give any Missouri clinic your child's private @familystork address. They send records; the timeline builds itself. No portal logins, no uploads, nothing for the clinic to learn.
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