Special Meal Accommodations 

Medical Statement for Children with Special Dietary Needs

Each special dietary request must be supported by a statement explaining the requested food substitution and must be signed by a recognized medical authority. The Medical Statement must include:

  • An identification of the medical or other special dietary condition which restricts the child’s diet;
  • The food or foods to be omitted from the child’s diet; and
  • The food or choice of foods to be substituted.

If we do not receive a medical statement from a recognized medical authority, your child will receive a regular lunch tray.  Medical statements completed by parents or guardians will not be accepted.

Modification Request Form