District Quill

August 19, 2020Does Your Child Have Special Dietary Needs? (AZ and NV)

Does your child have dietary restrictions or need special accommodations for meals?

If so, you will need to submit a medical form detailing the needs of your child. Part of this form will need to be filled out by a licensed healthcare professional. The seven medical professionals listed are permitted to complete and sign a medical statement for meal accommodations:

  • Dentists
  • Homeopathic Physicians
  • Naturopathic Physicians
  • Nurse Practitioners
  • Osteopathic Physicians
  • Physician Assistants
  • Physicians

Please note that having your child’s dietary needs on record with the campus Health Office is not sufficient. Due to HIPPA regulations, you need to submit the form below to our Nutrition Coordinator, to have dietary information communicated to food services.

Please submit the form at your earliest convenience, so we can begin preparing meal accommodations for your child as soon as possible. Click here for access to the Arizona form and here for access to the Nevada form.

Once the form has been completed, please email it to our Nutrition Coordinator Scarlett DeLaney. This will ensure that your child’s needs are kept on file for the kitchen staff.