This form should be completed for all students with food allergies, intolerance or milk substitution needs. After completing this form please bring it to the front desk or give to our Nutrition Director, Shauna Carlson. Please be aware that according to federal and state regulations this form must be signed by a licensed Medical Physician (M.D.), Physician Assistant (P.A.), Osteopathic Physician (D.O.), Advance Practice Registered Nurse (A.P.R.N.), or Naturopathic Physician (N.D. or N.M.D.).