Students with a Disability: Alpine Union will provide special diets to students with disabilities or medical conditions that limit a major life activity such as breathing or learning; for example, severe food allergy that results in life-threatening anaphylaxis. A current Medical Statement to Request Special Meals and/or Accommodations must be completed and signed by a licensed physician. This medical statement must be completed in its entirety and returned to your child’s school administration office. This form should be updated annually.

Students without a Disability: Alpine Union is not required to make food substitutions for children with non-disabling conditions. The District may accommodate students without disabilities who are medically certified as having a special medical or dietary need on a case-by-case basis. Examples include food intolerances or allergies that do not cause life-threatening reactions. To make modifications or substitutions to the school menu, schools must have a written Medical Statement to Request Special Meals and/or Accommodations completed and signed by a recognized medical authority (licensed physician, physician assistant, or nurse practitioner).

Lactose Intolerance: The District offers soy milk to children who cannot drink cow's milk due to lactose intolerance or milk allergy/sensitivity. To request soy milk for your child, please submit a written request from a recognized medical authority, or from a parent/guardian using the Parental Request for a Fluid Milk Substitution form. Please notify the appropriate Child Nutrition employee for your child’s school, to ensure soy milk is available.

Personal Preferences: Unfortunately, Alpine Union is unable to accommodate special diets based on personal preferences or religious convictions. We address this by offering a variety of menu options every day in the form of choices. By offering choices (protein, grain, fruit, vegetables, and milk), each child can customize a meal that suits his or her appetite and food preference.

Parental Request for a Fluid Milk Substitution Form

Medical Statement to Request Special Meals and/or Accommodations

Specification Index of All Foods Served

In accordance with Federal civil rights law and U.S. Department of Agriculture (USDA) civil rights regulations and policies, the USDA, its agencies, offices, and employees, and institutions participating in or administering USDA programs are prohibited from discriminating based on race, color, national origin, sex, disability, age, or reprisal or retaliation for prior civil rights activity in any program or activity conducted or funded by USDA.Persons with disabilities who require alternative means of communication for program information (e.g. Braille, large print, audiotape, American Sign Language, etc.), should contact the Agency (State or local) where they applied for benefits. Individuals who are deaf, hard of hearing or have speech disabilities may contact USDA through the Federal Relay Service at(800) 877-8339. Additionally, program information may be made available in languages other than English.To file a program complaint of discrimination, complete theUSDA Program Discrimination Complaint Form, (AD-3027) found online at: http://www.ascr.usda.gov/complaint_filing_cust.html, and at any USDA office, or write a letter addressed to USDA and provide in the letter all of the information requested in the form. To request a copy of the complaint form, call(866) 632-9992. Submit your completed form or letter to USDA by:(1) mail: U.S.

Department of Agriculture
Office of the Assistant Secretary for Civil Rights
1400 Independence Avenue, SW
Washington, D.C. 20250-9410;
(2) fax: (202) 690-7442; or(3) email: program.intake@usda.gov.

This institution is an equal opportunity provider.