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Special Dietary Needs

Medical Statement for Special Dietary Needs


A fillable form for requesting special dietary accommodations that can be completed electronically or printed and filled out by hand. This form provides guidance and documentation for special dietary requests.

Special Dietary Needs Example Policy

glass of milk

The School Nutrition Team has created an example Special Dietary Needs policy that can be used at your school or district. Please note, this template should be thoroughly reviewed and modified to fit the needs of your school or district. All highlighted areas are meant to be filled in to reflect your school(s) or district.

Fluid Milk Substitutions

glass of milk

School Food Authorities (SFAs) may offer students a fluid milk substitute that is nutritionally equivalent to cow's milk without a signed medical statement. If your SFA would like to offer a fluid milk substitute to your students, please complete and submit the approval form below.


Training & Resources


Maggie Byrne, RDN, CD
Public Health Nutritionist
(608) 267-9206
Michelle Zvonar
Nutrition Program Consultant
(608) 267-9125