Special Dietary Requests

Diet Modification Information

Big Foot Union High School will accommodate food allergies as confirmed by a licensed medical practitioner.

  • "Practitioner" is defined by Wisconsin State Statue 118.29(1)(e): any physician, dentist, optometrist, physician assistant, advanced practice nurse prescriber, or podiatrist licensed in any state. Food allergy documentation but be signed by one of these practitioner.

Medical Practitioner's statement for child must identify:

  • The child's disability

  • An explanation of why the disability restricts the child's diet

  • The major life activity operation of a major bodily function affected by the disability

  • The food or foods to be omitted from the child's diet and the food or choice of foods that must be substituted.

To approve your child for food allergy accommodations, please download the form below and return with the medical practitioner's signature. Pease send the completed form to your child's Food Service Director:

Brenda Utesch at BFHS, P.O. Box 99, Walworth, WI 53184, Email: Brenda Utesch

Within 1 week of receiving the completed form, a parent/guardian will be contacted and informed if meal & beverage substitutions will be provided or if more information is needed. It is the responsibility of the household to provide appropriate foods/beverages until informed otherwise. 

 Diet Modification Form: English   Español