Food Allergies and Special Dietary Needs of Students
Federal regulations require the school to receive written instructions from an appropriate medical authority before the school can modify your child's meals. A recognized medical authority must complete one of the following forms to document your child's current special dietary needs.
- Medical Statement to Request School Meal Modification for Student with Special Dietary Needs Due to Disability OR Food Allergy/Intolerance: If the student has a disability that affects his/her diet, a licensed physician must complete the form OR if the student has a food allergy or intolerance, a physician or other recognized medical authority (i.e. physician's assistant or nurse practitioner) must complete the form.
- Medical Discontinuation of School Meal Modifications Prescribed by a Medical Authority: If the student no longer needs meal modifications the form must be completed by a licensed medical authority.
The medical authority must list on the form all foods that are to be eliminated from the diet and foods that may be substituted.
The appropriate medical statement should be dated no earlier than July 1, 2010. To ensure your student's special dietary needs are met on the first day of school, return the completed medical statement by August 1, 2010 to Gina Lee, 1745 W. Grand, Haysville, KS 67060.
Important: Please sign the appropriate medical statement. If the school staff need additional information to clarify how to carry out the diet prescription, your signature is required for the physician or medical authority to share information with the school.
The following are links to the letters and forms USDA has provided regarding Special Dietary Needs of Students
Form 19-B: Medical Statement to Request School Meal Modification
Form 19-C: Discontinuation of School Meal Modifications Prescribed by a Medical Authority
