Special Dietary Request / Food Allergy Form

USF Dining makes it a priority to accommodate students with dietary restrictions and food allergies. It is also in our best effort to accommodate students whose diet may differ due to religious and cultural backgrounds. You are not only in good hands with trained staff, but we also have a registered dietitian available to all meal plan holders. To better help us with your specific needs, please fill out the following form and attach any medical documentation describing restrictions due to food allergy/intolerance or condition. Please be sure to email Karina Falcone with any additional questions, falcone-karina@aramark.com. 
*Please indicate if you are a:
*Food Allergy:
Only check wheat for wheat allergy, not for Celiac disease.
*Food Intolerance:
Other Dietary Restrictions:
Please list any other medical condition or religious observances requiring special dietary needs or restrictions here.
*Is the student under care of a physician for their food allergy or food-based condition?
*What are the medically necessary accommodations to help manage the health of the student?
*What are the preferred food substitutions, if any?
(dairy alternative, gluten-free bread, etc.)
*What types of contact will cause a reaction?
*Please explain:
*What are the student’s possible reactions to the above-indicated allergen(s) or conditions?
*Does the student understand the food allergy or medical condition, how to manage it, and keep necessary medication with them?
Is there any other information you would like to share to help us better meet the student’s needs?