If your child has a medically-necessary dietary need, and your child will eat meals provided by the Nutrition Services Department, you will need to have your child’s doctor complete a Diet Modification Request Form. If you need a form, you can obtain one by printing off the forms below. These forms will need to be signed by a physician licensed by the state (DO, MD, PA or ARNP only – Chiropractors are not accepted) and returned to Nutrition Services Department. New forms only need to be submitted if the accommodations your student receives need to change (example: better tolerance of dairy and student no longer needs to exclude cheese).

Diet Modification Request Form