The following is Cusick School Districts policy for students with Special dietary need.

     All Cusick students are provided with a packet that includes Dietary health information and emergency medical treatment form.  Health history forms are collected by the teachers and turned into the office secretaries; the secretaries then forward the health history forms to the school nurse. Information is then taken off the health form that has been filled out by the student’s parent. If any clarification is needed, parents are called to verify food allergies, intolerances and to what extent the allergy are. This information is then distributed to the student’s teacher, food service manager, secretaries, and paraeducators. The request for special dietary accommodations form is then mailed out to the parents for a licensed medical authority to sign. These forms can be signed by a Medical Doctor (MD) Doctor of Osteopathy (DO) Physician’s Assistant (PA) or practitioner (ARNP). Parents are advised to have their students doctor fill out and sign this form and return to the school as soon as possible, or within 35 days. This form should include what foods to omit/avoid and how ingesting impacts the child, also what foods to substitute. In the meantime, the kitchen staff will begin providing a reasonable modification to keep the child safe, while we wait for the dietary health form to be returned. If family does not return the form after 35 day the school will not accommodate the special dietary needs. All special dietary accommodation forms will be kept confidential in the school nurse’s office, and the food service kitchen.
     For assistance in completing the special dietary form, please contact the
school nurse, Cusick School District 509-445-1125

Request for Special Dietary Accommodations form