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Special Dietary Needs

Special Dietary Needs

If your child requires special dietary meal accommodations from the cafeteria, please read the following to determine which form is required to be submitted: 
 

Special Dietary Needs (Allergies, Intolerances, Modified Textures):  A Medical Statement to Request Special Meals and/or Accommodations form must be submitted. The form must be filled out in English and signed by a U.S. licensed physician, physician’s assistant, or nurse practitioner. 
 

Lactose Intolerance (Fluid Milk Only):  Milk is offered during breakfast and lunch as an optional beverage that students are not required to take. If your child has an intolerance to fluid cow’s milk and no other food allergies and you would like soy milk or Lactaid to be offered in place of regular milk due to dietary needs, please submit a Parental Request for a Fluid Milk Substitution form.
 

Please submit forms to the student’s school health clerk.

pdfMedical Statement to Request Special Meals (CNP 925 Rev. 03/23)
pdfParental Request Form for Fluid Milk Substitute (SNP 26 Rev. 12/22)

USDA NONDISCRIMINATION STATEMENT

In accordance with federal civil rights law and U.S. Department of Agriculture (USDA) civil rights regulations and policies, the USDA, its agencies, offices, employees, and institutions participating in or administering USDA programs are prohibited from discriminating based on race, color, national origin, religion, sex, disability, age, marital status, family/parental status, income derived from a public assistance program, political beliefs, or reprisal or retaliation for prior civil rights activity, in any program or activity conducted or funded by USDA (not all bases apply to all programs). Remedies and complaint filing deadlines vary by program or incident.

Persons with disabilities who require alternative means of communication for program information (e.g., Braille, large print, audiotape, American Sign Language, etc.) should contact the state or local agency that administers the program or contact USDA through the Telecommunications Relay Service at 711 (voice and TTY). Additionally, program information may be made available in languages other than English.

To file a program discrimination complaint, complete the USDA Program Discrimination Complaint Form, AD-3027 [3 (PDF), found online at How to File a Program Discrimination Complaint and at any USDA office or write a letter addressed to USDA and provide in the letter all of the information requested in the form. To request a copy of the complaint form, call 866-632-9992. Submit your completed form or letter to USDA by:

  1. mail:

U.S. Department of Agriculture

Office of the Assistant Secretary for Civil Rights 1400 Independence Avenue, SW, Mail Stop 9410 Washington, D.C. 20250-941O;

  1. fax:

202-690-7442; or

  1. email:

Program.lntake@usda.gov.

This institution is an equal opportunity provider.