Special Diet

Special Meal Accommodations

This Special Diet Statement is ONLY for a participant with a disability that affects the diet.  This form must be: 
  • Thoroughly completed and signed by a licensed physician
  • Submitted to the school/center/site before any meal modifications will be made in the USDA Child Nutrition Programs.
  • Updated whenever the participant's diagnosis or special diet changes.
Requests for Dietary Substitutions
Dietary substitutions are governed by both federal and state regulations.  Those regulations and Pipestone Area School procedures are summarized below.
Requests for substitutions require a statement from a licensed medical provider.  The statement must include both the items the student cannot eat and the items that may be substituted for it.  These must be re-written yearly by the start of the current school year and must be on file in the Food Service Directors Office.
All requests for substitutions other than milk will be decided on a case-by-case basis.  Child Nutrition staff members are not trained medical providers and will never determine if a child can or cannot eat a particular item.  That decision belongs only to parents, guardians, or licensed medical providers.
Parents, guardians or involved medical providers are welcome to visit our kitchens and review the ingredient statements on labels at any time by making an appointment with the Food Service Director.  However, a manufacturer may change the composition of any product at any time without notification.
For the most accurate information available, please contact the Food Service director to arrange a time to look at the package levels that concern you.
Lactose Intolerance
 The responsibility of a school food program to provide substitutions for any child with lactose intolerance is specified in state law (Minnesota Statutes section 124D.114).  Under this law, a school district or nonpublic school that participates in the National School Lunch Program or School Breakfast Program and recieves written request from a parent/guardian shall make available:
  • Lactose-reduced or lactose-free milk;or
  • Milk fortified with lactase in liquid, tablet, granular or other form;or,
  • Milk to which lactobacillus acidophilus has been added.
The school is not allowed to substitute juice (fruit or vegetable) or any soy-or rice-based beverage that is not nutritionally equivalent to cow"s milk for a participant who is lactose intolerant.
Dietary subsitution form for children without a disability click here
Dietary subsitution form for children with a disability click here



USDA Regulation 7 CFR Part 15b requires substitutions or modifications in school meals for children whose disabilities restrict their diets. A child with a disability must be provided substitutions in foods when that need is supported by a signed statement from a licensed physician.

In Cases of Food Allergy

Generally, children with food allergies or intolerances do not have a disability as defined under either Section 504 of the Rehabilitation Act or Part B of IDEA, and the school food service may, but is not required to, make food substitutions for them.  However, when in the licensed physician’s assessment, food allergies may result in severe, life-threatening (anaphylactic) reactions, the child’s condition would meet the definition of “disability”, and the substitutions prescribed by the licensed physician must be made.

Allergy Glossary

School food service may make food substitutions, at their discretion, for individual children who do not have a disability, but who are medically certified as having a special medical or dietary need.  Such determinations are only made on a case-by-case basis.  This provision covers those children who have food intolerances or allergies, but do not have life-threatening reactions (anaphylactic reactions) when exposed to the food(s) to which they have problems.

Medical Statement for Children with Special Dietary Needs

Each special dietary request must be supported by a statement explaining the requested food substitution and must be signed by a recognized medical authority. The Medical Statement must include:

  • An identification of the medical or other special dietary condition which restricts the child’s diet;
  • The food or foods to be omitted from the child’s diet; and
  • The food or choice of foods to be substituted.


If we do not receive a medical statement from a recognized medical authority, your child will receive a regular lunch tray.  Medical statements completed by parents or guardians will not be accepted.