Home
Schools

South Washington County Schools

Special Diet Statement

Special Diet Statement – Click Here to Access Form

Frequently Asked Questions:

How do I develop a plan to accomodate my child's dietary needs?

  • Obtain a copy of the Special Diet Statement to Request Dietary Accommodations from the Health Services staff or from the Nutrition Services webpage.
  • As specified on the Special Diet Statement have the recognized medical authority for the accommodation fill out the form in its entirety and ensure it has been signed prior to sending the form to the school.
  • Return the form to Health Services and discuss the plan.
  • Health Services will give a copy of the special diet statement to Nutrition Services.
  • Nutrition Services will make accommodations to the menu based on the special diet statement.  If further information is needed, the Nutrition Services staff will contact the parent or legal guardian.   

What is the special diet statement for a participant with a disability?

The special diet statement is a form which provides information about the child, the reason for which the diet must be modified, defines which foods are to be omitted and substituted and is signed by a recognized medical authority based on whether the student has a disability, food allergy, medical condition or a need for a fluid milk substitution. The form will need to be filled out and signed before any meal modifications will be made.

Who is considered to be a recognized medical autority?

A Licensed Physician, Physican's Assistant or an Advanced Practiced Nurse

How often does the special diet statement need to be renewed?

The form will need to be renewed whenever the participant’s special diet needs to be changed.  If changes are not needed, a new form will not need to be renewed on a yearly basis.

Can you submit a new special diet statement mid-year?

Yes, anytime there is a change, a new statement needs to be filled out and signed by the appropriate medical authority.