If your student requires dietary accommodation, please review the below information and complete the appropriate dietary accommodation form.

Before completing a dietary accommodation request from, please note:

• A new form must be completed each school year and each summer.
• Dietary accommodations are tracked at the school level. If your student transfers to another DCPS school, the form must be resubmitted with updated school information included.
• Dietary accommodation forms are to be submitted to the school nurse.
• Forms must be complete before accommodations can be met; including parent/legal guardian signatures and licensed medical provider signatures (when applicable).
• It is the responsibility of the parent/legal guardian to provide current medical/nutritional needs of the student, submitting new forms as needed.
• It can take 3-4 weeks from the time forms are received by Food and Nutrition Services from the school nurse for dietary accommodations to be made in the cafeteria. Please be sure to prepare for other accommodations during this time.

Please select the timeframe for which your student requires dietary accommodation:

School Year 2019-2020

USDA Nondiscrimination Statement

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 the USDA Program Discrimination Complaint Form, (AD-3027) found online at: How to File a Complaint, 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: [email protected].

This institution is an equal opportunity provider.

District of Columbia Human Rights Act

Also, the District of Columbia Human Rights Act, approved December 13, 1977 (DC law 2-38; DC official code §2-1402.11(2006), as amended) states the following:

It shall be an unlawful discriminatory practice to do any of the following acts, wholly or partially for a discriminatory reason based upon the actual or perceived: race, color, religion, national origin, sex, age, marital status, personal appearance, sexual orientation, gender identity or expression, family responsibilities, genetic information, disability, matriculation, or political affiliation of any individual. To file a complaint alleging discrimination on one of these bases, please contact the District of Columbia’s Office of Human Rights at (202) 727-4559 or [email protected].

DCPS Food and Nutrition Services Contact Information

For more information contact Robert Jaber at [email protected]