Medical Instructions

Please Note:  There are new inspectors and administrators that set our requirements.  There are changes to what has been previously required of us in the past.  These are changes stipulated by the State of Missouri.


PHYSICAL:  You must submit the Missouri Department of Health and Senior Services report BCC-6A, Child Medical Examination Report (Infant/Toddler/Pre-School). This is a single page document. This physical must have been performed since August 17, 2019 (within one year of the beginning of our 2020-2021 school year).   This form must be signed by a physician or a registered nurse under the supervision of a physician. Please note there is an additional form for Kindergarteners:  You must submit the Missouri Department of Health and Senior Services report BCC-6B, Parent’s Health Statement for School-Age Child.  This is a single page document.


IMMUNIZATIONS:    Per the Missouri Department of Health and Senior Services, “Satisfactory evidence of immunization means a statement, certificate, or record from a physician or his or her designee, other recognized health facility, immunization registry, school record, or child care record stating that the required immunizations have been given to the individual. This statement, certificate, or record shall provide documentation of the specific antigen and the month, day, and year of vaccine administration.”   We can accept the Missouri Department of Health and Senior Services report ImmP-1, Missouri Immunization Record (two-sided document), OR any form from your physician’s office meeting the above requirements.  Also find attached the forms for Preschool and School Age (Kindergarten) Immunization Requirements for the state of Missouri.  As a private school, our policy is to only enroll students who are current on the required immunizations to protect our staff and other students.

On August 28, 2015, a new law regarding immunizations went into effect:

In accordance with Section 210.003.7, RSMo., the parent or guardian of a child enrolled in or attending a day care, preschool or nursery school, may request a notice of where there are any children enrolled at our facility, Sacred Heart Villa, with an immunization exemption on file.  If you would like to request this information, please contact Kris Doder and the information will be provided to you.  Please note, the names or names of individual children are confidential and will not be released.  Our response will be limited to whether or not there are children enrolled at our facility with an immunization exemption on file.


LEAD:  The State of Missouri requires that childcare facilities located in designated areas record an ANNUAL Evidence of Lead Testing.  Please find the attached single page form.  We can accept the attached form with parental refusal OR a physician’s record of any test performed since August 17, 2019 (within one year of the beginning of our 2020 - 2021 school year).


CHILD CARE ENROLLMENT FORM:  Per the Missouri Department of Health and Senior Services, we have a new form, DC-105, Child Care Enrollment Form for License-Exempt Facilities, that must be completed in full for each child.  This is a two-sided form.


MEDICATION AUTHORIZATION: For each and every medication to be administered at our facility, the Missouri Department of Health and Senior Services report BCC-11, Medication Authorization must be submitted. This is a single page form.  Please note the differing requirements on the form for prescription medication and non-prescription medication.  In addition, for prescriptions, Sacred Heart Villa requires physician’s orders that detail the full name of student as well as the name, dosage, route and intervals of medications along with the reason for medication/diagnosis.  Please see the handbook for additional criteria for medication administration at our facility.


Please call the office at 314-771-2224 should you have any questions regarding any of these forms.  All forms must be on file NO LATER THAN AUGUST 1STWE CANNOT ADMIT CHILDREN TO SCHOOL THAT DO NOT HAVE THESE FORMS ON FILE.  Thanks so much for your cooperation!