Non-Medical Dietary Requests for CHUFSD Child Nutrition Program
If your child has a medical allergy, please contact your school nurse to  modify and/or confirm your child's record.

If you would like to make a non-medical request, please submit your request via this form.

Example: ("Gluten Intolerance", "No Sweets for my child on Wednesdays" or "No chips for my child on Fridays")
Sign in to Google to save your progress. Learn more
Clear selection
Parent/Guardian Name
Student Name
Grade Level
Non - Medical Dietary Request:
Clear form
Never submit passwords through Google Forms.
This form was created inside of Croton Harmon School District. Report Abuse