Special Diet Statement

School Food Authorities will make reasonable substitutions to meals on a case-by-case basis for children who are considered to have a disability that restricts their diet. To make such a request, parents need to submit a Special Diet Statement that is completed by a licensed physician, physician assistant, or an advanced practice registered nurse, such as a certified nurse practitioner. Updates to this form are only required when a child's needs change.

Frequently Asked Questions:

How do I develop a plan to accommodate my child's dietary needs?

  • Obtain a copy of the Special Diet Statement to Request Dietary Accommodations from the Health Services staff or from the Nutrition Services webpage.
  • As specified on the Special Diet Statement have the recognized medical authority for the accommodation fill out the form in its entirety and ensure it has been signed prior to sending the form to the school.
  • Return the form to Health Services and discuss the plan.
  • Health Services will give a copy of the special diet statement to Nutrition Services.
  • Nutrition Services will make accommodations to the menu based on the special diet statement. If further information is needed, the Nutrition Services staff will contact the parent or legal guardian.

What is the special diet statement for a participant with a disability?

The Special Diet Statement is a form which provides information about the child, the reason for which the diet must be modified, defines which foods are to be omitted and substituted and is signed by a recognized medical authority based on whether the student has a disability, food allergy, medical condition or a need for a fluid milk substitution. The form will need to be filled out and signed before any meal modifications will be made.

Who is considered to be a recognized medical authority?

A Licensed Physician, Physician's Assistant or an Advanced Practice Nurse

How often does the special diet statement need to be renewed?

The form will need to be renewed whenever the participant’s special diet needs to be changed. If changes are not needed, the current form will follow your student from grade to grade.

Can you submit a new special diet statement mid-year?

Yes, anytime there is a change, a new statement needs to be filled out and signed by the appropriate medical authority.