Special Diet Order Form

Please refer to the Special Diet webpage for the procedure for obtaining the Special Diet Order.
This file contains the instructions and form for all Special Diet Requests.  The purpose of this form is to record the student's disability requiring dietary modifications of school meals and the changes needed.  This form needs to be filled out by the parent or guardian and a physician or registered dietitian annually.  Examples of special diet requests include:  Texture Modifications, Nutrient Modifications, Diabetes, Food Allergies, or any other type of medically necessary modifications for students. 
If you have any questions, please call the Child Nutrition Office for assistance.
Special_Diet_Form_New.pdf, 71.68 KB; (Last Modified on August 31, 2015)