Medical Statement (for special dietary needs)


The Medical Statement form is needed to accommodate medical disabilities that require special meal modifications.  This form is required for medically necessary accommodations to be provided.

An authorized medical professional needs to complete and sign the Medical Statement form.

Return the signed Medical Statement form to your School Office.

For religious preferences, please contact the Food Services Program with your request,  Do not use the Medical Statement form for religious preferences.



MEDICAL STATEMENT TO REQUEST Special Meals - Accommodations.doc, 70 KB; (Last Modified on September 12, 2022)