JOIN UTES SHAC!!!!
Special Diet Request DOCTOR FORM
INSTRUCTIONS AND GUIDELINES
1. A Special Diet Request Form MUST be completed EVERY school year.
2. The student’s medical authority must complete, sign, and submit an updated Special Diet
Request Form to request new, more, and/or different accommodations.
3. The parent/guardian may choose to waive the medical signature for a subsequent school year, if
less (but not different) and/or the same accommodations are requested. If applicable, the
parent/guardian must complete, sign, and submit the medical waiver section at the top of the
form.
4. Please submit the form to the UTES Food Service Manager via the student’s campus front office;
or you may email the form directly to the UTES Food Service Manager at
kimberlywilson@austin.utexas.edu
5. Special Diet requests will be reviewed by the Campus Nurse and Food Service Manager.
6. Accommodations will be processed by the Child Nutrition Services Staff in accordance with
federal and state guidelines.
7. The school’s food service staff is unable to make any special diet accommodations until the
request is processed and implemented by the UTES Nurse and Food Service Manager
8. A special diet request may take up to two weeks to implement. However, at the beginning of
the school year the implementation period may be longer due to the very high number of
requests that are received at this time. During the implementation period, the parent/guardian
of the student is responsible for providing the special diet.
9. The UTES CNS staff will make every attempt to reasonably accommodate students when the
medical condition is not life threatening.
10. The student’s campus nurse will be notified when a special diet request has been implemented;
if you would like to know if your child’s special diet has been implemented, please contact your
child’s campus nurse; or you may contact the Food Service Manager directly at 512-495-3304.
11. It is the parent/guardian’s responsibility to notify the UTES CNS department of any changes to
the diet; or if the student transfers to another school.
12. When a parent/guardian signs the Special Diet Request Form, he/she agrees to the special diet
request made by the medical authority and gives the UTES Food Service Manager permission to
process the request as written; if you have any questions or concerns about how the medical
authority completed the form for your child and would like to make changes, please contact the
UTES Food Service Manager at 512-495-3304.
13. The UTES CNS department has the right to contact the medical authority to clarify the medical
request.
14. All forms and information regarding special diet accommodations can be found on the UTES
Food Menu and Café website; if you have additional questions, please call the UTES Food
Service Manager at 512-495-3304.
UTES Child Nutrition Services
Austin, TX 78702
512-495-3300
This is an equal opportunity provider
Eat like a little longhorn… Join us in the cafe with your student during breakfast or Lunch!
Breakfast 7:15am-8am
Lunch 10:50am- 12pm
Payment due upon receipt (CASH OR CHECK ONLY)
Full Lunch Tray $6 (drink included)
Full Breakfast Tray $5 (drink included)
Just Entrée $2
Just a side $1
Just Fruit 50₵
Coffee or Hot Tea (refills included) $2
**50₵ discount on coffee if you bring your own cup!!
Milk Carton 50₵
Iced Tea (refills included) 50₵
WELLNESS GUIDELINES
As a University of Texas demonstration school, we are leading the way in promoting healthy and active lifestyles. Therefore, we go above and beyond the requirements of the National Free and Reduced Lunch Program. Below you will find federal, state, and UTES standards for food items served and provided for in school.
FEDERAL AND STATE STANDARDS
- Foods with Minimal Nutritional Value (FMNV) are restricted during 7:10 a.m. to 3:30 p.m. This includes candy, soda, popsicles, chips, and caffeinated beverages, including energy drinks.
- Competitive Foods, including all food and beverages that are not provided by school foodservice, may not be served.
- Three school events throughout the school year may be designated as a special time for consuming FMNV determined by the school administrator.
- Campus approved field trips are not exempt from the nutrition policy.
- Parents providing their child’s lunch may not provide food to any other child other than their own.
CLASS / BIRTHDAY PARTIES
Each class has a limit of three class parties per year. Your child’s teacher will communicate in advance information regarding class parties. Parties are typically held at Winter Holiday, Valentine’s Day and at the end of the year. Parents are invited to participate in class parties. Birthday parties are not allowed in the classroom and invitations may not be passed out at school unless every student is invited. Parents are able to coordinate a special snack for the class to enjoy after lunch time. Please follow state guidelines about nutrition by providing healthy treats rather than cakes, cupcakes and cookies. Balloons or other floral decorations are not allowed in the classroom. Those delivered remain in the front office until the end of the day.
Have you seen Chef Kimberly’s pet crab Kobe?
Kobe is a climbing crab from Hawaii and is in the grandson of Chef Kim’s old crab Wannetta. He enjoys hiding in odd places around the kitchen and spying on the kids in the service line. Every night he climbs around the café in search of bits of food and a new place to hide. Do not get too close to him or you may get pinched! He’s a snappy little crabby!!
When in line at the café look around the kitchen for her and tell the chef’s if you see him…
Additional Info: