Breakfast & Lunch Program
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Middle High School:
Carver Elementary
NOTICE OF DIETARY NEEDS/RESTRICTIONS
Medical Statement for Children with Special Dietary Needs
Each special dietary request must be supported by a statement explaining the requested food substitution and must be signed by a recognized medical authority. The Medical Statement must include:
- An identification of the medical or other special dietary condition which restricts the child’s diet;
- The food or foods to be omitted from the child’s diet; and
- The food or choice of foods to be substituted.
If we do not receive a medical statement from a recognized medical authority, your child will receive a regular lunch tray. Medical statements completed by parents or guardians will not be accepted.
MEDICAL STATEMENT TO REQUEST SPECIAL MEALS AND/OR ACCOMMODATIONS: https://www.doe.mass.edu/cnp/civilrights/attachment-a.pdf