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Rochester Public Schools Student Nutrition Services 615 7th St SW Rochester, MN 55902 5073284250 Fax 5073284209 kapaul@rochester.k12.mn.us Dear Parent(s)/Guardian(s), According to the National School

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How to fill out special diet statement

How to fill out a special diet statement:

01

Start by providing your personal information, such as your full name, contact details, and date of birth.

02

Indicate the reason for your special diet needs. For example, if you have allergies, specific dietary restrictions, or medical conditions that require a modified diet.

03

Include information about any medications or treatments you are currently undergoing that may affect your dietary requirements.

04

Specify the type of special diet you require, whether it is vegetarian, vegan, gluten-free, lactose-free, low-sodium, or any other specific dietary need.

05

Provide details about any specific food items or ingredients that you need to avoid or include in your diet.

06

Mention any symptoms or reactions you experience when consuming certain foods, if applicable.

07

If necessary, attach any supporting documents or medical reports that validate your need for a special diet.

08

Sign and date the special diet statement to confirm its accuracy.

09

Keep a copy for your records and submit the original statement to the relevant authority or institution that requires this information.

Who needs a special diet statement:

01

Individuals with medical conditions such as diabetes, celiac disease, food allergies, or intolerances may require a special diet statement.

02

People following specific dietary preferences or restrictions, such as vegetarians or vegans, may need to provide a special diet statement to ensure their dietary needs are accommodated.

03

Students or employees who require special meal accommodations at schools, universities, or workplaces may be asked to submit a special diet statement.

04

Patients staying in hospitals or receiving medical care may need to provide a special diet statement to ensure their dietary needs are met during their stay.

05

Athletes or individuals undergoing specific fitness or training programs may require a special diet statement to optimize their performance and recovery.

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What is special diet statement?

Special diet statement is a document outlining the dietary requirements and restrictions of an individual.

Who is required to file special diet statement?

Individuals with specific dietary needs, such as allergies or medical conditions, are required to file a special diet statement.

How to fill out special diet statement?

Special diet statements can be filled out by providing information about the individual's dietary requirements and restrictions.

What is the purpose of special diet statement?

The purpose of a special diet statement is to ensure that individuals receive appropriate meals based on their dietary needs.

What information must be reported on special diet statement?

Information such as specific dietary restrictions, allergies, medical conditions, and food preferences must be reported on a special diet statement.

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