Special Diet Requests

Any diet modifications must be requested by a recognized medical authority (licensed doctor/physician, nurse practitioner, physician assistant). If your child requires a special diet, please have your licensed physician complete the required Dickinson ISD Food and Nutrition Services Dietary Special Request Form, available for download from our website.  No diet modifications will be made until the physician completed form is returned to Dickinson ISD Food and Nutrition Services.  If we do not receive a completed Dickinson ISD Allergy Form from a recognized medical authority (licensed doctor/physician, nurse practitioner, physician assistant), your child will receive a regular meal tray.  Medical statements completed by parents or guardians will not be accepted. It is preferred that an updated form be completed by the physician and turned into Dickinson ISD Food and Nutrition Services annually. 

DISD Diet Modification Form 22-23

DISD Diet Modification Form Spanish 22-23

Kelsi Robinson MDS, RD, LD

FNS Assistant Director and Dietitian

krobinson@dickinsonisd.org

Please FAX form to: 281-229-6013