2019-2020 Dietary Accommodations
GSLP strives to accommodate your family's ethical, cultural, or religious dietary restrictions when serving food to your child at school. Please use the following form to describe any special diet your family follows that you would like your child to follow at school. (Complete this form even if your child has no dietary restrictions.)

***List any food allergies or restrictions due to chronic medical conditions on the Health Care Plan as well.***

Email address *
Child's First Name *
Your answer
Child's Last Name *
Your answer
Child's 2019-2020 Class *
Dietary Information
Dietary Restrictions
Please check below if your child should adhere to any of the following dietary restrictions:
Describe Dietary Restrictions
If you checked a dietary restriction above, please describe anything GSLP should know about your child's dietary restrictions so that we can help your child adhere to them.
Your answer
Foods Your Child CANNOT Eat
ITEMS THAT YOU CHECK OFF BELOW WILL **NOT** BE SERVED TO YOUR CHILD AT SCHOOL.

Check off any food items your child **SHOULD NOT** be served at school due to an allergy, medical restriction, cultural restriction, or ethical restriction.

PLEASE NOTE: Do not check off items your child simply does not like to eat. We encourage but do not force children to try new foods at preschool as part of teaching children about health and nutrition.

Specific Food Restrictions
Check the box next to any foods your child is not permitted to consume at school.
Milk in Processed Food
If you checked "Milk" or "Milk Products" above: May your child have milk if it is part of a cooked or processed food, such as cake or crackers?
Eggs in Processed Food
If you checked "Eggs" above: May your child have eggs if they are part of a cooked or processed food, such as cake or crackers?
Other Foods to Avoid
Please list any other foods to avoid and state the reason they should be avoided. Be sure to list any food allergies or medical dietary restrictions on your child's Health Care Plan as well.
Your answer
Electronic Signature *
Type your full name below to sign this form.
Your answer
Today's Date *
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A copy of your responses will be emailed to the address you provided.
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