Food Allergy Form

This Special Diet Statement is only for a participant without a disability who is medically certified as having a special dietary need.  This form should be updated whenever the participant’s diagnosis or special diet changes.  Please fill out the below form and return it to Jill Steiner, school nurse in the main office.  If you have any questions or concerns, please feel free to contact Jill at 320-392-5621. 

Special Diet Statement Form