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123 E Powell Blvd #300 Gresham, OR 97030 5034892528 CHILD AND ADULT CARE FOOD PROGRAM (CA CFP) MEDICAL STATEMENT FOR MILK SUBSTITUTIONS Part 1: To be completed by parent, guardian, or adult daycare
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How to fill out medical statement for milk

How to fill out a medical statement for milk:
01
Obtain the medical statement form: Contact your healthcare provider or the organization requesting the medical statement for milk to obtain the necessary form.
02
Fill out personal information: Provide your full name, date of birth, and contact information in the designated fields on the form.
03
Specify the milk-related condition: Clearly state the medical condition or allergy that requires you to have a special diet that includes milk. Provide any relevant details or medical documentation, if required.
04
Include healthcare provider information: Fill in the details of your healthcare provider, including their name, contact information, and any relevant credentials.
05
Sign and date the form: Read through the entire form, ensuring that all necessary information is provided accurately. Sign and date the form in the designated area to confirm its authenticity.
06
Submit the completed form: Follow the instructions provided by the organization requesting the medical statement for milk. This may involve submitting the form electronically, by mail, or in person.
Who needs a medical statement for milk?
01
Individuals with lactose intolerance: People with lactose intolerance have difficulty digesting lactose, the sugar found in milk. They may require a medical statement to request alternative options or substitutes for milk in their diet.
02
Those with milk allergies: People with milk allergies experience an adverse immune response to milk proteins. They may require a medical statement to ensure they receive dairy-free or lactose-free alternatives.
03
Individuals with specific medical conditions: Some medical conditions, such as certain gastrointestinal disorders or chronic illnesses, may necessitate a special diet that includes milk. A medical statement may be needed to ensure that the individual's dietary needs are met.
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What is medical statement for milk?
Medical statement for milk is a form that verifies the medical need for consuming milk or a milk substitute.
Who is required to file medical statement for milk?
Students or individuals who require milk or a milk substitute as part of a special diet are required to file a medical statement for milk.
How to fill out medical statement for milk?
To fill out a medical statement for milk, one must provide detailed information about the medical condition that requires the consumption of milk or a milk substitute, as well as information about the healthcare provider who prescribed the special diet.
What is the purpose of medical statement for milk?
The purpose of a medical statement for milk is to ensure that individuals who require milk or a milk substitute for medical reasons are provided with the appropriate accommodations.
What information must be reported on medical statement for milk?
The medical statement for milk must include the individual's name, medical condition requiring the special diet, healthcare provider's information, and the specific dietary requirements.
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