Cypress School District

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Child Nutrition Services » Special Dietary Needs

Special Dietary Needs

If your child requires special dietary modifications from the cafeteria, please read the following to determine which form is required to be submitted:
  • Cultural & Religious Food Preferences:  Child Nutrition Services is committed to offering a variety of menu items that meet our community's cultural food choices. Vegetarian options are always available for both breakfast and lunch. If you would like an alert message on your student's account to avoid certain foods such as beef, pork, or all meat products, please contact Parisa Shukla at

  • Lactose Intolerance (Fluid Milk Only):  Milk is offered during breakfast and lunch as an optional beverage that students are not required to take. If you would like soy milk or Lactaid to be offered in place of regular milk due to dietary needs, please submit a Parental Request for a Fluid Milk Substitution form.

  • All Other Special Dietary Needs (Allergies, Intolerances, Modified Textures):  A Medical Statement to Request Special Meals and/or Accommodations form must be submitted. The form must be filled out in English and signed by a U.S. licensed physician, physician’s assistant, or nurse practitioner. An alert message will be added to your student's account and substitutions will be provided based on the guidance of the healthcare provider.
Forms are required to be submitted annually; they do not continue from the previous year. If you need any assistance completing the forms, please contact Child Nutrition Services at (714) 220-6948. If your student changes schools, please notify the Child Nutrition Services office.

Please send all forms directly to Parisa Shukla at or in person at 9739 Denni Street, Cypress, CA 90630.

Non-Discrimination Statement


In accordance with Federal civil rights law and U.S. Department of Agriculture (USDA) civil rights regulations and policies, the USDA, its Agencies, offices, and employees, and institutions participating in or administering USDA programs are prohibited from discriminating based on race, color, national origin, sex, disability, age, or reprisal or retaliation for prior civil rights activity in any program or activity conducted or funded by USDA.


Persons with disabilities who require alternative means of communication for program information (e.g. Braille, large print, audiotape, American Sign Language, etc.), should contact the Agency (State or local) where they applied for benefits. Individuals who are deaf, hard of hearing or have speech disabilities may contact USDA through the Federal Relay Service at (800) 877-8339.  Additionally, program information may be made available in languages other than English.


To file a program complaint of discrimination, complete the USDA Program Discrimination Complaint Form, (AD-3027) found online at: and at any USDA office, or write a letter addressed to USDA and provide in the letter all of the information requested in the form. To request a copy of the complaint form, call (866) 632-9992. Submit your completed form or letter to USDA by:


(1)   mail: U.S. Department of Agriculture

Office of the Assistant Secretary for Civil Rights

1400 Independence Avenue, SW

Washington, D.C. 20250-9410;


(2) fax: (202) 690-7442; or (3) email:


This institution is an equal opportunity provider.