MPS Culinary & Wellness Services (CWS) provides special dietary accommodations for meals and/or snacks on a case-by-case basis for participants with a documented medical condition or disability that restricts their diet. According to the ADA Amendments Act, most physical and mental impairments that substantially limit or affect one or more major life activities or bodily functions will constitute a disability. MPS CWS does not provide dietary accommodations for requests related to religious, moral convictions or personal preference.
To process your request for special diet accommodations, a signed special diet request form must be provided. Annual updates to this form are recommended to best support student’s needs. Any changes in dietary needs requires a new form completed by the student's health care provider.
For food allergies, intolerances, disabilities, or medical conditions:
- The Special Diet Statement (found on page 2 of this form) must be fully completed and signed by a licensed healthcare provider.
- Licensed physician, physician assistant, registered dietitian, or an advanced practice registered nurse, such as a certified nurse practitioner may sign the form.
- Incomplete forms will delay processing.
- Caregivers can choose to sign the Voluntary Authorization to grant MPS access to protected health information as necessary to provide dietary accommodations.
- Return completed form to CWS Dietitian.
For lactose free milk:
- Caregivers must complete the blue section on page 1 of the request form. Requests for lactose free milk only require a parent/guardian signature.
- Note: Completing this request will provide lactose free milk to drink and will not result in dairy free milk or lactose free meals. See instructions above to request dairy free milk or meals through the Special Diet Statement.
- Return completed form to CWS Dietitian.
Completed forms can be returned by email (ask.dietitian@mpls.k12.mn.us), fax (612-668-2830), or mail (812 Plymouth Ave N, Mpls 55411). Please allow 10-14 days for processing and implementing dietary accommodations. CWS Dietitian will follow up with caregivers with further instructions after the request has been processed.