Get Special Diet & Allergy Request Form

Filling out the Special Diet & Allergy Request Form online is an essential task for ensuring dietary accommodations for individuals with specific needs. This guide will walk you through the process to complete the form accurately and efficiently.

Follow the steps to complete the Special Diet & Allergy Request Form.

1. Press the ‘Get Form’ button to access the Special Diet & Allergy Request Form in your browser.
2. In Part A, enter the student’s name, age, school name, grade level, and classroom. Ensure accuracy in these fields to facilitate proper identification and accommodation.
3. Indicate whether the child has a disability by selecting 'Yes' or 'No.' If 'Yes,' describe the major life activities impacted by the disability in the space provided.
4. Next, determine if the child has special nutritional or feeding needs. If 'Yes,' complete Part B and have it signed by a licensed physician.
5. If the child is not disabled but has special nutritional or feeding needs, choose 'Yes' and ensure Part B is completed and signed by a recognized medical authority.
6. For those not requiring special meals, the parent can sign at the bottom of the form and return it to the school food service.
7. In Part B, list any dietary restrictions, allergies, or food intolerances that must be avoided. Provide specific details for any substitutions and texture modifications needed.
8. If special equipment or utensils are necessary for the child’s eating, be sure to indicate that in the appropriate section.
9. Include any additional comments that may help the food service understand the child’s eating and feeding patterns.
10. Once all sections are complete, ensure the parent signs and dates the form. The physician or medical authority must also provide their signature and date if required.
11. After reviewing the information for accuracy, save changes to the form, and choose to download, print, or share it as necessary.

Complete your Special Diet & Allergy Request Form online today to ensure your dietary needs are met.