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Food Allergy Form and Information

Please follow the instructions listed below to notify the school district if your student has a food allergy and changes are needed to the school menu:

  • Print the Medical Statement for food allergies form listed below.
  • Have a physician, M.D. or D.O. or a Nurse Practitioner fill out the form completely and sign as well as parent signature.
  • Return to the nurse at the school your student will be attending.

*If a student's food allergy alert needs to be removed, please have a detailed written note submitted to the nurse at the school your student is attending or an updated food allergy form can be completed by the student's Physician or Nurse Practitioner.

Food allergy form

Food allergy policy

* New direction from DESE and the USDA:  If a food item is processed in a facility that also processes other items that contain allergens, that food item will now be considered to have those additional allergens.