Student Medical and Allergy Forms

We understand and respect each individual student's nutritional needs. To ensure your child is provided with special meal accomodations based on medical needs, please complete the following forms and email the completed form(s) to Stephanie Jarvis, Assistant Director of Child Nutrition Services at [email protected]

Medical Statement Request Form

This form is to provide Child Nutrition Services with special dietary needs and physician instructions for medical accommodations per Section 504 of the Rehabilitation Act of 1973. This form requires a physician's signature.

Milk Substitution Request Form

This form is to provide Child Nutrition Services with the need for a milk substitute due to a medical or other special dietary need

Disputes

If you do not agree with the decision or results of a verification, you have the right to a fair hearing, which may be requested by calling or writing the hearing official at––

Sergio San Martin

350 W. Brookside Ave.

Beaumont, CA 92223

P. 951-845-1631

This institution is an equal opportunity provider.