SUMMER FOOD SERVICE PROGRAM

SFSP link:

www.fns.usda.gov/summerfoodrocks

Special Dietary Needs Statement

Suggested Dietary Needs Statement:

The district makes accommodations for children who are unable to eat the school meals because of a disability that restricts their diet. In order to make modifications or substitutions to the school meal, the district must have a written Medical Statement on file that is signed by a State recognized medical authority (licensed physician, physician assistant, certified registered nurse practitioner, or dentist).

The statement must identify:

• The child's disability

• An explanation of why the disability restricts the child's diet

• The major life activity affected by the disability

• The food(s) to be omitted from the child's diet

• The food or choice of foods that must be provided as the substitute