September 1, 2011


To:          Teacher

CC:          School Health Nurse



Re: Student


[Student Name] is happy to be in your class this year at [School Name]. Before the school year begins, I wanted to alert you to the fact that [Student Name] has Celiac Disease.  Celiac Disease is an autoimmune disease that is triggered by ingesting gluten, a protein found in wheat, barley, rye, malt, and sometimes oats.


[Student Name] is actually very healthy, but he must manage Celiac Disease with a strict adherence to a gluten-free diet. It is very important to his health that he remains gluten free.  He has an individual Health Plan on file in the School Health Clinic.  I have enclosed a copy of the last updated form for your review.


Since we are not yet familiar with the procedures for activities and food in your class, I am providing this information to you in order for [Student Name] to avoid any possible contact with gluten while in your class.


We will provide [Student Name] with a gluten-free lunch and snack everyday. He is well aware of his condition, and understands that he cannot trade snacks or eat any other food without first confirming with an adult that it is gluten-free.  [Student Name] is very comfortable with his food restrictions, but still may need reminders or help reading labels. Any product with WHEAT, BARLEY, RYE, MALT or OATS on its ingredient list is off limits. He must also avoid any products that indicate a possible cross contamination with the same as above, such as “made in a facility that also processes WHEAT.”


In addition to food, [Student Name] should also avoid contact with craft products that contain gluten.  Of most concern to me are play dough, pasta, hay/straw, fingerpaints and paper mache, since they are products that almost always contain wheat and/or are likely to get under his fingernails.  Other products that may contain wheat are glue, paint, and ink. To be clear, [Student Name] does not get a reaction just from touching gluten, however if it gets on his hands and fingers it could be transferred to his mouth. I would be happy to review the ingredients of any craft products in the classroom to determine if they do contain gluten. If they do, I will be happy to provide [Student Name] with a suitable substitution.


If [Student Name] does accidentally come into contact with gluten at school, I ask that you immediately have him wash his hands thoroughly. He does not have an allergic response, such as anaphylaxis, so no medicine nor medical attention is required. I simply request that you make me aware of the contact with the gluten (via a phone call or email) so that I can monitor his health and possible reactions.


If you allow students to bring in birthday treats to share, I ask that we be made aware of it a day or two in advance. Cupcakes and cookies, unless made with special alternative flours, are not gluten-free. If notified in advance of what will be brought in, [Student Name] can bring a gluten-free alternative in order to celebrate with the other students. If it works better for you, I can provide you with a small box or bag of safe, gluten-free treats to store in the classroom for [Student Name].


I want to make it as easy as possible for you and [Student Name] this year. If you are not comfortable determining what is and is not gluten-free, then please call or email me about any food products being offered to him during class activities. This would include food craft projects, birthday celebrations, holiday celebrations, field trips, class rewards, etc. If, for some reason you are unable to reach me, then I ask that you do not allow [Student Name] to eat any food that did not come from our home.


For your information, I have enclosed documents that provide more detailed information about Celiac Disease.  I would be happy to meet with you and/or the school nurse to review the situation and discuss any questions or concerns you may have about it. I know as a teacher you have a lot of students and responsibilities, and I appreciate your time and attention to the matter.


Thank you,



[Your Name and Contact Information]




Standard Health Care Plan

“What Is Celiac Disease?”