Due to the School Nutrition Program being regulated by different laws than the rest of the school district, a separate form and process is required in order to make accommodations in the cafeteria.

The School Nutrition Program is required to make accommodations to a student's meal offerings if the student has a medical or physical impairment that restricts the child's diet. This may include students with disabilities as defined in the Americans with Disabilities Act and the Individuals with Disabilities Education Act. This accommodation can be written into the student's Individual Education Plan and/or Section 504 plan. The School Nutrition Program will make efforts to collaborate with the School Health Team, School Counselor, and/or staff at a child's individual school to ensure their dietary needs are met. To request an IEP or Section 504 meeting to determine eligibility, please contact your school counselor or principal. Accommodations will only be made for medically necessary reasons.

All special dietary requests are processed at School Nutrition's Central Office and must be submitted on the current Medical Request for School Meal Modifications. This form must be completed and signed by a licensed healthcare provider which may be a medical doctor, podiatrist, nurse practitioner, physician's assistant, dentist, optometrist, or osteopathic physician. This form must be reviewed and approved by the School Nutrition Central Office Staff prior to accommodations being made.

The licensed healthcare provider must include the following information on the Eating and Feeding Form for an accommodation to be made:

  1. A description of the mental or physical condition/impairment(s).
  2. A description of how the mental or physical condition/impairment(s) restricts the student's diet.
  3. A statement of the accommodation(s) requested for this student. This could include foods to avoid and substitutions, specific grams of carbohydrates required per meal for a student with diabetes.
  4. Licensed healthcare provider's signature.

The School Nutrition Program will not request medical records or laboratory results, but may contact the licensed healthcare provider if the diet prescription and/or requested accommodation needs clarification.

Please note: The information on the Eating and Feeding Evaluation Form is considered a diet order or diet prescription and the cafeteria staff must follow it accordingly once submitted and approved by the School Nutrition Program. If the student's physical or mental condition changes and the dietary restrictions subsequently change, the licensed healthcare professional must submit a new form to the School Nutrition Office. The School Nutrition Staff cannot take verbal orders from providers or parents about the change of a medical condition. Once the new form is submitted and approved by the School Nutrition Central Office staff, the new accommodation(s) will be honored. If parents no longer wants accommodations for their child, the parent may submit the request in writing.

For more information on special dietary requests, please contact Ausrine Paulauskaite, Supervisor of Nutrition Services/Registered Dietitian at (423) 498-7286 or via email.

USDA Non-Discrimination Statement

In accordance with federal civil rights law and U.S. Department of Agriculture (USDA) civil rights regulations and policies, this institution is prohibited from discriminating on the basis of race, color, national origin, sex (including gender identity and sexual orientation), disability, age, or reprisal or retaliation for prior civil rights activity.

Program information may be made available in languages other than English. Persons with disabilities who require alternative means of communication to obtain program information (e.g., Braille, large print, audiotape, American Sign Language), should contact the responsible state or local agency that administers the program or USDA’s TARGET Center at (202) 720-2600 (voice and TTY) or contact USDA through the Federal Relay Service at (800) 877-8339.

To file a program discrimination complaint, a Complainant should complete a Form AD-3027, USDA Program Discrimination Complaint Form which can be obtained online at: https://www.usda.gov/sites/default/files/documents/USDA-OASCR%20P-Complaint-Form-0508-0002-508-11-28-17Fax2Mail.pdf, from any USDA office, by calling (866) 632-9992, or by writing a letter addressed to USDA. The letter must contain the complainant’s name, address, telephone number, and a written description of the alleged discriminatory action in sufficient detail to inform the Assistant Secretary for Civil Rights (ASCR) about the nature and date of an alleged civil rights violation. The completed AD-3027 form or letter must be submitted to USDA by:

  1. mail:
    U.S. Department of Agriculture
    Office of the Assistant Secretary for Civil Rights
    1400 Independence Avenue, SW
    Washington, D.C. 20250-9410; or
  2. fax:
    (833) 256-1665 or (202) 690-7442; or
  3. email:
    [email protected]

This institution is an equal opportunity provider.