Allergies & Unique Mealtime Needs

DPS School Nutrition Services is committed to providing delicious, quality meals to ALL students. In order to support your student's unique mealtime needs, we need medical forms on file. You can download, complete, and return the appropriate forms (below) to your school nurse, school administrator, and/or directly to School Nutrition Services. If you have any questions, please contact Braedyn Mallard, Registered Dietitian/Nutrition Coordinator, DPS School Nutrition Services (braedyn_mallard@dpsnc.net; 984.278.2637).

MILK SUBSTITUTION REQUEST FORM

If your student cannot drink the regularly provided cow's milk, you can fill out a milk substitution form. Once School Nutrition Services receives the form, your student will be offered Organic Soy Milk instead of cow’s milk. Please note: students are not required to take milk with breakfast or lunch.

Milk Substitution Form - ENGLISH

Formulario de Sustitución de Leche - SPANISH

ALLERGIES & UNIQUE MEALTIME NEEDS FORM             

DPS will adapt your student's meals if your student has a medical-based food restriction. Examples of medical-based food restrictions include allergies, specific disabilities, and medical conditions that require a special diet. You must complete the Medical Statement form and it must be signed by your student's doctor or medical provider. Changes approved in IEPs will also be made. Changes because of religion or personal reasons cannot be made. If you are interested in supporting the development of delicious, culturally relevant menu items, please contact Dr. Thayer to find out how you can get involved with future planning for DPS school food. 

Please submit the medical form each year at the beginning of the school year, or as soon as you learn a diet change is needed. 

Forms are available from your cafeteria manager, at the School Nutrition Services Central Office and here:

• Medical Statement.pdf

• Expediente Médico.pdf

How to complete the form: 

• Parents/guardians fill out part A. 

• A licensed medical provider must fill out Part B.

• Turn in the form to the student's teacher, school nurse, or cafeteria manager.

• The form will be reviewed by the SNS Nutrition Coordinator who will create the meal changes in collaboration with the student, family, school nurse, therapist, etc. as needed.

• Once the student is satisfied with the plan, the meal changes will be communicated to the student's school cafeteria manager. 

• The family will be contacted if further information is needed.