Get Special Meal Prescription Form From The Nh Department Of Education

This guide provides detailed instructions on how to fill out the Special Meal Prescription Form from the New Hampshire Department of Education online. By following these steps, users can ensure that they complete the form accurately and efficiently.

Follow the steps to complete the form online.

1. Click ‘Get Form’ button to obtain the form and open it in the designated platform.
2. Fill in the local school district or name of institution, including street address, city, and zip code.
3. Provide the student's name, date of birth (DOB), and SASID (Student Identification Number).
4. Indicate the school name or institution if it differs from the one listed above.
5. Select the disability or medical condition by choosing one option from the provided list.
6. Check all applicable options under the special diet section, indicating specific dietary needs.
7. Specify the effective date for the diet modifications, indicating the start date.
8. Describe the condition requiring the special diet in the provided text area.
9. For each food category (meats/proteins, vegetables/fruits, grains/breads/cereals, milk/dairy products, fats/sauces, combination foods), indicate what the student cannot have by checking the relevant options.
10. Specify food preparations required for each category, if applicable, by selecting from provided options.
11. If applicable, indicate tube feeding requirements and specify the formula required.
12. Describe any additional needs related to safe eating and the environment required during meals.
13. In the physician/medical authority signature section, ensure that the physician or medical authority signs, dates, and provides their printed name and office phone number.
14. In the parent/guardian section, indicate acceptance or decline of accommodations offered, followed by the parent's or guardian's signature and date.
15. After completing the form, users can save their changes, download, print, or share the completed form as needed.

Complete the Special Meal Prescription Form online to ensure dietary needs are met.