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DORCHESTER SCHOOL DISTRICT TWO 20232024 NUTRITIONAL SUPPLEMENT REQUEST FORM The following is to be completed by a physician/legal prescriber. Name of Student: ___ DOB: ___ Grade/Section: ___ Name

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How to fill out 2023-2024 nutritional supplement request

01

Obtain the nutritional supplement request form for the year 2023-2024.

02

Fill out your personal information including name, contact information, and address.

03

Provide relevant details about your dietary needs and restrictions.

04

Specify the duration for which you require the nutritional supplement.

05

Submit the completed form to the appropriate authority for review and approval.

Who needs 2023-2024 nutritional supplement request?

01

Individuals who have specific dietary needs or restrictions and require nutritional supplements for the year 2023-2024.

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What is nutritional supplement request form?

The nutritional supplement request form is a document used to formally request approval for the use of nutritional supplements within a specific program or institution.

Who is required to file nutritional supplement request form?

Individuals or entities that wish to obtain or provide nutritional supplements, such as healthcare providers, dietitians, or organizations managing nutritional programs, are typically required to file this form.

How to fill out nutritional supplement request form?

To fill out the nutritional supplement request form, applicants must provide accurate information regarding the type of supplement, dosage, purpose, and relevant patient or program details as instructed on the form.

What is the purpose of nutritional supplement request form?

The purpose of the nutritional supplement request form is to ensure that the proposed nutritional supplements are evaluated for safety, effectiveness, and appropriateness before being approved for use.

What information must be reported on nutritional supplement request form?

The form typically requires information such as the name of the supplement, its ingredients, dosage, intended use, rationale for use, and any relevant medical history or dietary needs.

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