Meal Modification Request
Milton Town School District follows the guidance published by the United States Department of Agriculture Food and Nutrition Service entitled "Accommodating Children with Disabilities in the School Meal Programs: Guidance for School Food Service Professionals."
The document explains that the Americans with Disabilities Act of 1990 distinguishes between:
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A physical or mental impairment that substantially limits one or more major life activities of such individual
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A record of such an impairment
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Being regarded as having such an impairment
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A preference that a child eat a specific diet because the parent or guardian believes it is healthier for the child
In a disability situation, as described above, MTSD will require a medical statement to make a meal modification. A general health concern is not a disability and does not require schools to make a modification.
MTSD has adopted the procedure below for parents/guardians to request meal modifications for their students with disabilities.
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Download this Special Dietary Medical Statement created by the Vermont Agency of Education Child Nutrition Programs.
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Ask your child's doctor to complete the above form, if necessary. The form is a fillable pdf, if you download it and open it with Adobe.
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If a child's IEP or 504 already contains the specific meal modification required, the parent/guardian only needs to complete the top of the form and submit via the Google form, below.
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If a child's IEP or 504 does NOT contain the specific meal modification required, the HUUSD requires the information on the form and that the doctor sign by hand or use a signature stamp in the Signature field.
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Complete the Google form to finish the process. Google Form
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You will need to upload the Special Dietary Medical Statement signed or stamped by your child's doctor (if signature required).
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Complete the Google form even if your child's IEP or 504 already contains the information about the meal modification.
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The school will follow up with the doctor as necessary.
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Please email Child Nutrition Manager Jackie Hoff at [email protected]
Jackie will work with the school nurse to verify that all the provided information is correct or if we need more information.
We will work with the school nurse and food & nutrition team in each school to follow doctor's recommendations on how to provide meal modifications to your student.
In accordance with federal civil rights law and U.S. Department of Agriculture (USDA) civil rights regulations and policies, this institution is prohibited from discriminating on the basis of race, color, national origin, sex (including gender identity and sexual orientation), disability, age, or reprisal or retaliation for prior civil rights activity.
Program information may be made available in languages other than English. Persons with disabilities who require alternative means of communication to obtain program information (e.g., Braille, large print, audiotape, American Sign Language), should contact the responsible state or local agency that administers the program or USDA’s TARGET Center at (202) 720-2600 (voice and TTY) or contact USDA through the Federal Relay Service at (800) 877-8339.
To file a program discrimination complaint, a Complainant should complete a Form AD-3027, USDA Program Discrimination Complaint Form which can be obtained online at: https://www.usda.gov/sites/default/files/documents/USDA-OASCR%20P-Complaint-Form-0508-0002-508-11-28-17Fax2Mail.pdf, from any USDA office, by calling (866) 632-9992, or by writing a letter addressed to USDA. The letter must contain the complainant’s name, address, telephone number, and a written description of the alleged discriminatory action in sufficient detail to inform the Assistant Secretary for Civil Rights (ASCR) about the nature and date of an alleged civil rights violation. The completed AD-3027 form or letter must be submitted to USDA by:
- Mail:
U.S. Department of Agriculture
Office of the Assistant Secretary for Civil Rights
1400 Independence Avenue, SW
Washington, D.C. 20250-9410; or - Fax:
(833) 256-1665 or (202) 690-7442; or - Email:
[email protected]