We accommodate disabilities as defined by the government. According to the USDA, a disability is "a physical or mental impairment that significantly limits one or more of an individual's major life activities.

We acknowledge the following as disabilities:

• Food Allergies:
  • "Big 9" (wheat, soy, milk, eggs, sesame, peanuts, tree nuts, fish, shellfish)
  • Other less common allergens
• Medical Conditions:
  • Lactose Intolerance
  • Celiac's Disease
  • Diabetes Mellitus
  • G6PD
  • Other medical conditions that affect dietary needs

If your child has a disability that affects their diet, we invite you to fill out the correct form on this page and return it to us as soon as possible. 

Special Diet Form

This form is for newly diagnosed allergies or allergies that you would like us to add to our system. This form is also for changing allergy management instructions.

Directions

Parents/guardians must fill out the top box and a Licensed Physician, Physician's Assistant, or Registered Nurse Practitioner must fill out the bottom box. Have the medical provider submit the completed form to the email or fax listed on the bottom of the form.

Note to Parents/Guardians: While you are in the process of getting the Special Diet Form filled out and submitted to us, please pack all your child's meals and snacks. Please continue to pack your child's meals while our Registered Dietitian builds a modified menu for your child. This is necessary, as we need time to review food labels for your child's safety and to order special products if needed. The Registered Dietitian will reach out to you as soon as the modified menu is built for you to review and approve, and will specify a menu start date. 

Allergy Removal Form

This form is for incorrect or outgrown allergies or allergies that you would like us to remove from our system. This form is NOT for changing allergy management instructions. If you would like to keep an allergy in our system but change how we manage it, please refer to the Special Diet Form, above.

Directions

Parents/guardians must fill out the entire form and submit it to the Registered Dietitian (RD). This can be done by emailing the completed form directly to the RD or handing the form to a Chartwells employee in the cafeteria. A doctor's signature is not required for this form.

Note to Parents/Guardians: We must follow the doctor's instructions until we have new documentation of your child's allergies or medical conditions. Once we receive the completed Allergy Removal Form, we are able to remove the requested allergies from our system and start serving your child according to the new information on the same-day. 

District Policies

Food Allergy Management Policy

2023 Letter on Food Substitutions

Contact Us

For questions about accommodations, please reach out to:

Monique Mazaika, RDN, CPFM She/her/hers

• Email: mmazaika@pmsd.org
• Phone: (570)839-7121 x80455
• Fax: (570)839-3133