Diet Modification Request Form

Students who have special dietary needs due to a disability, as defined by the Rehabilitation Act of 1973, or life-threatening (anaphylactic) reactions to specific foods, must be provided substitutions in food when that need is supported by a “Diet Modification Request Form” signed by a licensed physician.

Students who have lactose intolerance may receive soy milk as a substitute for milk during breakfast and lunch. Juice and water are not acceptable substitutions because they are not nutritionally equivalent to milk. Parents are required to submit a written request to the Nutrition Services office to receive a milk substitute.

Diet Modification Request Form