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KS Medical Statement to Request School Meal Modification 2013-2025 free printable template

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Medical Statement to Request School Meal Modification Important! Select the applicable meal modification category from the three listed below. Then carefully read and follow the procedures for that
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How to fill out KS Medical Statement to Request School Meal

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How to fill out KS Medical Statement to Request School Meal Modification

01
Obtain the KS Medical Statement form from your school or school district's website.
02
Fill in the student's personal information such as name, date of birth, and grade level.
03
Provide details about the medical condition that necessitates the meal modification.
04
Specify the type of meal modifications required for the student (e.g., allergy-friendly, gluten-free).
05
Include recommendations from the student’s healthcare provider or a registered dietitian if necessary.
06
Review the form for accuracy and completeness before submission.
07
Submit the completed KS Medical Statement to the school’s food service department or designated school official.

Who needs KS Medical Statement to Request School Meal Modification?

01
Students with food allergies or medical conditions that require special meal accommodations.
02
Parents or guardians seeking meal modifications for their children due to health-related issues.
03
School staff responsible for accommodating dietary restrictions in the school meal program.
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The KS Medical Statement to Request School Meal Modification is a form used to request modifications to school meal plans for students with medical conditions that require dietary adjustments.
Parents or guardians of students who have specific medical conditions or disabilities that necessitate changes to their school meals are required to file the KS Medical Statement.
To fill out the KS Medical Statement, the parent or guardian must provide their contact information, the student's details, the specific medical condition, and the requested meal modifications. A healthcare provider must also sign the document.
The purpose of the KS Medical Statement is to ensure that students with medical needs receive appropriate meal accommodations that align with their dietary restrictions for health and safety.
The KS Medical Statement must include the student's name, date of birth, specific medical condition, list of dietary limits, and any alternative foods or meals that can be served, along with a signature from a licensed healthcare provider.
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