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(Meals Provided During the School Day)

Special Diet Accommodations

If a student requires special meal accommodations a School Meal Modification Statement must be provided.  This documentation must be signed by a licensed Physician, Physician’s Assistant, or Advanced Practice Nurse such as a nurse practitioner. (Note that this does not include Chiropractors, Dietitians, or Health Coaches.) Review the following steps to ensure your request can be processed in a timely manner. 

1. A licensed medical professional diagnoses an allergen or special dietary need. 

• Please note that WBSD#7 is not required to accommodate special dietary requests that do not constitute a disability, including requests related to religious or moral convictions or personal preference. If these requests are accommodated, all USDA meal pattern and nutrient requirements must be met. 

• According to the ADA Amendments Act, most physical and mental impairments that substantially limit or affect one or more major life activities or bodily functions—including digestive functions, immune system, and neurological functions—will constitute a disability.

2. Parent/Guardian obtains the School Meal Modification Statement form—available online, School Office Personnel or School Nurse for new dietary needs. The medical statement must include what food or allergen should be avoided, a brief explanation for how exposure to the food affects the child, and foods to be substituted.

3. Parent/Guardian completes Participant Information (part A), Permission Information (part C) prior to providing the form for completion by a medical professional.  Parent/Guardian may complete Voluntary Authorization (part D) section if desired.

4. Licensed medical professional completes Required Information: Prescribed Diet Order (part B) additional Information, and Signature sections.
     

5. Parent ensures the completed form is sent to the District Nurse/School Office at the child's school.
     

6. Nurse emails or mails the form to the Dietitian. 
     

7. Dietitian reviews the form for completion and contacts parent/guardian, medical professional, and/or nurse with questions as needed.
     

8. Dietitian sends an email to the Kitchen Coordinator and District Nurse approving the special diet request along with instructions for accommodating the diet.  

   
   

9. Parent/Guardian is responsible for providing a new special diet statement if there are any updates or changes to current dietary forms on file. It is not necessary to provide a new special diet statement every school year if there are no dietary changes. 

To view a printable copy of the Food Allergy letter, click here.

To view a printable copy of the Meal Modification Form, click here.

In accordance with Federal civil rights law and U.S. Department of Agriculture (USDA) civil rights regulations and policies, the USDA, its Agencies, offices, and employees, and institutions participating in or administering USDA programs are prohibited from discriminating based on race, color, national origin, sex, disability, age, or reprisal or retaliation for prior civil rights activity in any program or activity conducted or funded by USDA. 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 Agency (State or local) where they applied for benefits. Individuals who are deaf, hard of hearing or have speech disabilities may contact USDA through the Federal Relay Service at (800) 877-8339. Additionally, program information may be made available in languages other than English. To file a program complaint of discrimination, complete the USDA Program Discrimination Complaint Form, (AD- 3027) found online at: http://www.ascr.usda.gov/complaint_filing_cust.html, 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 Washington, D.C. 20250-9410; (2) Fax: (202) 690-7442; or (3) Email: program.intake@usda.gov.

This institution is an equal opportunity provider.