School Nutrition » Special Dietary Needs

Special Dietary Needs

   food allergens 
Davidson County Schools Nutrition Program takes your child's health seriously. We promise to provide accommodations for students with food allergies. We understand communication and accommodation is a key factor in ensuring students are able to feel comfortable with food choices while living with allergies. If at any point you have questions or any concern about your child's needs please do not hesitate to contact the School Nutrition Department at 336-242-5635.                                            
SPECIAL DIETARY NEEDSMedical Statement Form
The Medical Statement for Students with Unique Mealtime Needs for School Meals helps schools provide meal modifications for students who require them.  Schools cannot change food textures, make food substitutions, or alter a student’s diet at school without proper documentation from the healthcare providers.   Completion of all items will allow your child’s school to create a plan with you for providing safe, appropriate meals and snacks to your child while at school.   Your participation in this process is very important.  The sooner you provide this signed and completed form to your child’s school, the sooner the School Nutrition Program and their staff can prepare the food your child needs.  Your signature is required for your school to take action on the Medical Statement.
 
 
The original Medical Statement is kept on file in the School Nutrition Department. A copy of the statement is kept on file with the School Cafeteria Manager and the School Nurse. Menu changes are made through the School Nutrition Department and are communicated to the School Cafeteria Manager and School Nurse (if requested).
Download the Medical Statement English or pick up a copy at the school.
 
 

Medical Statement for Students with Special Nutritional Needs for School Meals

When completed fully, this form gives schools the information required by the U.S. Department of Agriculture (USDA), U.S. Office for Civil Rights (OCR), and U.S. Office of Special Education and Rehabilitative Services (OSERS)  for meal modifications at school. See “Guidance for Completing Medical Statement for Students with Special Nutritional Needs for School Meals” for help in completing this form.

Medical Statement (English) 58 KB (Updated: April 30, 2014)
Medical Statement (Spanish) 89 KB (Updated: March 3, 2017)
Fluid Milk Substitution Form 100 KB (Updated: March 10, 2021)
 
 ALLERGEN INFORMATION
 
Please be aware that School Nutrition Services prepares our food in commercial kitchens, where cross-contact with food allergens is possible and where ingredient substitutions and recipe revisions are sometimes made. Additionally, manufacturers of commercial food products we order may change their product formulation or ingredient consistency at any time without notification. Actual ingredients and nutritional content may vary and we are not able to guarantee that any food item will be completely free of food allergens. If you have questions or any concerns regarding ingredients of a specific food or recipe, please reach out to the School Nutrition Office, at 336-242-5635.
 
ALLERGEN AWARENESS PLAN
 
School Nutrition Services is Allergen Aware and takes all necessary precautions to care for all Davidson County Schools' students.
 
Pic 
 
 
Non-Discrimination Statement

https://www.fns.usda.gov/civil-rights/usda-nondiscrimination-statement-other-fns-programs

This institution is an equal opportunity provider.