Special Dietary Needs Form

Background information:

The Americans with Disabilities Act (ADA) states that most physical and mental impairments constitute a disability. MCPS Division of Food and Nutrition Services (DFNS) works collaboratively with parents and other district staff to ensure an equal opportunity to participate in the school meal programs and receive program benefits. Schools are required to make substitutions to meals for students with a disability; these substitutions are on a case-by-case basis and only provided when supported by a written statement from a state-licensed healthcare professional—such as the Special Dietary Needs Form (page 1). Schools are required to make reasonable accommodations for students with disabilities that directly affect their diet. General health concerns, such as a preference that a student eat a gluten-free diet because a parent believes it is better for the student, are not disabilities and do not require accommodation. DFNS will design a meal plan within the nutrition program meal pattern to accommodate common disabilities. In most cases, disabilities can be managed within the meal pattern requirements. DFNS is not required to provide the specific substitution or other modification requested but will offer a reasonable modification that effectively accommodates the student’s disability and provides equal opportunity to participate in or benefit from the program.

Special Dietary Needs Form	89 K	English
Formulario de Necesidades Alimentarias Especiales	67 K	Spanish
Formulaire sur les Besoins Alimentaires Spéciaux	69 K	French
Đơn Nhu cầu Ăn kiêng Đặc biệt	123 K	Vietnamese
特殊飲食需要表	140 K	Chinese
특별식단 요청 양식	98 K	Korean
የልዩ አመጋገብ ፍላጎት ቅጽ	87 K	Amharic
Formulário de Necessidades Dietéticas Especiais	69 K	Portuguese

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