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Child Nutrition Medical Statement for Meal Modifications Little Rock School District Child Nutrition Department 1501 Jones Street, Little Rock, AR 72202 (501)4472450 child nutrition LSD.org PART ONE

How to fill out child nutrition medical statement

How to fill out child nutrition medical statement

1. Start by gathering all the necessary information such as the child's name, age, and any specific dietary restrictions or medical conditions.
2. Download a child nutrition medical statement form from a reputable source, such as the official website of your state's department of education or the United States Department of Agriculture (USDA).
3. Carefully read through the form to understand what information needs to be provided.
4. Fill out the child's personal information section, including their name, date of birth, and contact information.
5. Provide relevant medical information, such as allergies, dietary restrictions, or any other nutritional concerns.
6. If necessary, have a healthcare professional or doctor fill out the medical section of the form, documenting any specific instructions or recommendations for the child's nutrition.
7. Review the completed form to ensure all required information has been included and is legible.
8. Submit the filled-out child nutrition medical statement to the designated authority, such as the school or daycare center, as per their instructions.
9. Keep a copy of the filled-out form for your records in case of any future reference or updates.

Who needs child nutrition medical statement?

1. A child nutrition medical statement is needed for children who have specific dietary needs or medical conditions that require them to follow a special diet.
2. This may include children with food allergies, diabetes, celiac disease, lactose intolerance, or other conditions that require careful management of their nutrition.
3. The statement helps to ensure that the child's dietary needs are met and that appropriate accommodations are made by schools, daycare centers, or other institutions responsible for their meals.
4. Parents or guardians should consult with their child's healthcare provider to determine if a child nutrition medical statement is necessary.

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What is child nutrition medical statement?

A child nutrition medical statement is a document that provides specific dietary information and restrictions for a child, usually required for children with medical conditions or disabilities that affect their food intake.

Who is required to file child nutrition medical statement?

Parents or guardians of children with specific dietary needs or medical conditions are typically required to file a child nutrition medical statement with educational institutions or daycare providers.

How to fill out child nutrition medical statement?

To fill out a child nutrition medical statement, one must provide accurate information regarding the child's medical condition, dietary restrictions, and any alternate food options or accommodations needed, along with the signature of a licensed medical professional.

What is the purpose of child nutrition medical statement?

The purpose of the child nutrition medical statement is to ensure that children with special dietary needs receive appropriate meals that meet their medical requirements in educational and care settings.

What information must be reported on child nutrition medical statement?

The information that must be reported includes the child's name, date of birth, medical condition, specific dietary restrictions, recommended accommodations, and the medical professional's signature.