Allergy Information

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Allergy Information

Students with life threatening food allergies or disabilities requiring diet modifications may have an alert posted in the cafeteria point of sale (cash register).

The school nurse at the student’s school collects all special medical information and may pass that information on to the Child Nutrition office.

If food substitutions are required, please be sure the paperwork that is returned to the school nurse lists those substitutions.

Click here for Food Allergy Form

Click here for Food Allergy Form in Spanish

Click here for Food Allergy Procedure

Click here for Food Allergy Procedure in Spanish

Click here for Student List for Special Diets and Allergies

Click here for Discontinuation of Meal Modification Form

Click here for Discontinuation of Meal Modification Form in Spanish

Non-Discrimination Statement

In accordance with federal civil rights law and U.S. Department of Agriculture (USDA) civil
rights regulations and policies, this institution is prohibited from discriminating on the basis of
race, color, national origin, sex, disability, age, or reprisal or retaliation for prior civil rights
activity.
Program information may be made available in languages other than English. Persons with
disabilities who require alternative means of communication to obtain program information (e.g.,
Braille, large print, audiotape, American Sign Language), should contact the responsible state or
local agency that administers the program or USDA’s TARGET Center at (202) 720-2600 (voice
and TTY) or contact USDA through the Federal Relay Service at (800) 877-8339.
To file a program discrimination complaint, a Complainant should complete a Form AD-3027,
USDA Program Discrimination Complaint Form which can be obtained online at:
https://www.usda.gov/sites/default/files/documents/ad-3027.pdf from any USDA office, by
calling (866) 632-9992, or by writing a letter addressed to USDA. The letter must contain the
complainant’s name, address, telephone number, and a written description of the alleged
discriminatory action in sufficient detail to inform the Assistant Secretary for Civil Rights
(ASCR) about the nature and date of an alleged civil rights violation. The completed AD-3027
form or letter must be submitted to USDA by:
mail: U.S. Department of Agriculture Office of the Assistant Secretary for Civil Rights 1400
Independence Avenue, SW Washington, D.C. 20250-9410;
or fax: (833) 256-1665 or (202) 690-7442;
or email: program.intake@usda.gov
This institution is an equal opportunity provider.

Deklarasyon Non-Diskriminasyon

Dapre lwa federal dwa sivil yo ak règleman ak politik sou dwa sivil Depatman Agrikilti Etazini
(USDA), enstitisyon sa a entèdi pou fè diskriminasyon sou baz ras, koulè, orijin nasyonal, sèks,
andikap, laj, oswa reprezay oswa vanjans pou aktivite dwa sivil anvan yo.
Enfòmasyon sou pwogram yo ka disponib nan lòt lang ki pa Anglè. Moun ki gen andikap ki
bezwen lòt mwayen kominikasyon pou jwenn enfòmasyon sou pwogram nan (pa egzanp, Bray,
Gwo lèt, Kasèt odyo, Lang Siy Ameriken), ta dwe kontakte ajans leta oswa lokal ki responsab ki
administre pwogram nan oswa USDA TARGET Center a nan (202) 720-2600 (vwa ak TTY)
oswa kontakte USDA atravè Sèvis Relè Federal nan (800) 877-8339.
Pou depoze yon plent pou diskriminasyon nan pwogram, yon moun ki pote plent dwe ranpli yon
Fòm AD-3027, yo ka jwenn Fòmilè pou plent kont diskriminasyon nan pwogram USDA a sou
Entènèt nan : https://www.usda.gov/sites/default/fi..., nan nenpòt biwo USDA, lè w rele (866) 632-
9992, oswa lè w ekri yon lèt ki adrese a USDA. Lèt la dwe genyen non moun ki pote plent lan, adrès,
nimewo telefòn, ak yon deskripsyon alekri sou swadizan aksyon diskriminatwa a ak ase detay pou
enfòme Asistan Sekretè Dwa Sivil la (ASCR) sou nati ak dat yon swadizan vyolasyon dwa sivil
la. Fòm oswa lèt AD-3027 ki ranpli a dwe soumèt bay USDA pa :
lapòs : U.S. Department of Agriculture Office of the Assistant Secretary for Civil Rights 1400
Independence Avenue, SW Washington, D.C. 20250-9410;
oswa faks: (833) 256-1665 oswa (202) 690-7442;
oswa imel: program.intake@usda.gov
Enstitisyon sa a se yon founisè opòtinite egal.

Declaración de no discriminación

Para todos los demás programas de asistencia de nutrición del FNS, agencias estatales o
locales y sus subreceptores, deben publicar la siguiente Declaración de No Discriminación:
De acuerdo con la ley federal de derechos civiles y las normas y políticas de derechos civiles del
Departamento de Agricultura de los Estados Unidos (USDA), esta entidad está prohibida de
discriminar por motivos de raza, color, origen nacional, sexo, discapacidad, edad, o represalia o
retorsión por actividades previas de derechos civiles.
La información sobre el programa puede estar disponible en otros idiomas que no sean el inglés.
Las personas con discapacidades que requieren medios alternos de comunicación para obtener la
información del programa (por ejemplo, Braille, letra grande, cinta de audio, lenguaje de señas
americano (ASL), etc.) deben comunicarse con la agencia local o estatal responsable de
administrar el programa o con el Centro TARGET del USDA al (202) 720-2600 (voz y TTY) o
comuníquese con el USDA a través del Servicio Federal de Retransmisión al (800) 877-8339.
Para presentar una queja por discriminación en el programa, el reclamante debe llenar un
formulario AD-3027, formulario de queja por discriminación en el programa del USDA, el cual
puede obtenerse en línea en: https://www.fns.usda.gov/sites/default/files/resource-files/usda-
program-discrimination-complaint-form-spanish.pdf, de cualquier oficina de USDA, llamando al
(866) 632-9992, o escribiendo una carta dirigida a USDA. La carta debe contener el nombre del
demandante, la dirección, el número de teléfono y una descripción escrita de la acción
discriminatoria alegada con suficiente detalle para informar al Subsecretario de Derechos Civiles
(ASCR) sobre la naturaleza y fecha de una presunta violación de derechos civiles. El formulario
AD-3027 completado o la carta debe presentarse a USDA por:
(1)correo:
U.S. Department of Agriculture
Office of the Assistant Secretary for Civil Rights
1400 Independence Avenue, SW
Washington, D.C. 20250-9410; or
(2)fax:
(833)256-1665 o (202) 690-7442; o
(3)correo electrónico:
program.intake@usda.gov
Esta entidad es un proveedor que brinda igualdad de oportunidades.

Allergy Information