Physician’s Statement for Children with Disabilities

USDA regulations require substitutions or modifications in school meals for children whose disabilities restrict their diets. A child with a disability must be provided substitutions in foods when that need is supported by a statement signed by a licensed physician.

The physician’s 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 or foods to be omitted from the child’s diet and the food or choice of foods that must be substituted.

The attached form must be completed for Special Dietary Requests – Physician’s Form - Food Allergy/Special Dietary Needs/Disability Action Plan. Other physician forms will not be accepted. (Note Ms. Richter can you link the physician’s form here. The Physician’s form is found at www.squaremeals.org section 13, pages 13.34-13.35)

Each special dietary request must be supported by a statement that explains the food substitution that is requested.

Kenedy Independent School District Child Nutrition Department is not responsible for and cannot guarantee the accuracy of any of the nutritional information contained on this site. The information contained on this site is not intended as a substitute for advice from your physician or other healthcare professional.

Please provide a copy of the Physician’s Form to both the school nurse and child nutrition.

Menus are posted and parents are welcome to look at any ingredient label on food products onsite at the school cafeteria. Please request an appointment with the Food Service Director or Cafeteria Manager.

 

Accommodating Children with Special Dietary Needs

An individual with a special dietary need is one who does not have a disability, as defined by USDA, but is unable to consume a particular food because of a medical or other special dietary condition. The individual’s special dietary need and the needed substitution(s) must be supported by a medical statement from a licensed medical authority or other appropriate health professional as designated by the state. A person with special dietary needs may have a food allergy or intolerance (for example, lactose intolerance) but does not have life-threatening (anaphylactic) reactions when exposed to food(s) to which he/she is allergic.

 

The attached form must be completed for Special Dietary Requests – Physician’s Form - Food Allergy/Special Dietary Needs/Disability Action Plan. Other physician forms will not be accepted. 

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