If your child has a medically-necessary dietary need, and your child will eat meals provided by the Nutrition Services Department, you will need to have your child’s doctor complete a Diet Modification Request Form. If you need a form, you can obtain one by printing off the forms below, calling the nurse or health associate of the school your child attends, or contacting the Waukee Nutrition Services Department at 515-987-2719. These forms will need to be signed by an appropriately licensed provider (DO, MD, PA, ARNP, or Dentist only – Chiropractors are not accepted) and returned to the nurse where your student attends school or the District Office Nutrition Department. New forms only need to be submitted if the accommodations your student receives need to change. For example, better tolerance of dairy and student no longer needs to exclude cheese.
- Authorization for Dietary Identification Card
- Food Allergy Action Plan
- Diet Accommodations Process for Students with Special Dietary Needs
- Diet Modification Request Form 2023