Special Diet Forms

• Parent Non-Dairy Milk Form English / Padres formulario para leche no lacteada Español
• Creditable Non-Dairy Milks English / Leches no lácteas acreditables Español 
  • Non-dairy milk must have the same nutrients as dairy milk.
• Medical Statement for Meal Pattern Accommodation English  instrucciones para padres/tutores en Español
  • Required for low nutrient milks, such as almond milk or oat milk. 
  • Required for FDA Exempt infant formulas, such as Nutramigen or "hypoallergenic" infant formulas.
  • The child's doctor must document a disability OR an impairment to a major bodily function to be reimbursed for an item that does NOT meet the meal pattern. 
• Infant Formulas that Require a Physician's Statement / Fórmulas que requieren una declaración médica

​ English