Request for Special Dietary Accommodations Form

If your student is participating in our meal program and would like to request special dietary accommodation, please fill out a Request for Special Dietary Accommodations form. If you have submitted a special dietary accommodation request in the past, please contact Nutrition Services.

A Request for Special Dietary Accommodations Form must be completed in its entirety and signed by your student's physician (or a licensed health care professional authorized to write medical prescriptions in Washington State). The completed form must be turned in and reviewed with the family and the district dietitian before Nutrition Services can make adjustments in the published menu to meet a special dietary need. Please email the completed form to: and

•OSPI CNS Procedure for Handling Complaints of Discrimination

Child Nutrition Services Complaint & Discrimination Form 

RequestforSpecialDietaryAccommodations-2022.pdf, 199.54 KB; (Last Modified on February 17, 2023)