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Food Allergy Information

Below, you will find a list of informational pages and district forms concerning students with food allergies.


Food Allergy Management & Education Tool-Kit 2014

This valuable resource was created by doctors and allergy specialists at the Children's Hospital of St. Louis.

Pampa ISD Procedure for Requesting Special Dietary Modifications for Students
Parents/Guardians may print this as a guide in the process of acquiring special dietary modifications for a student, whether the student has a food allergy or food intolerance.


Dietary Modification Request Form
Parents/Guardians may print this form for a primary physician to fill out requesting a special dietary modification for a student. This form must be filled out annually or whenever a change is made to the dietary modification.

USDA Non-Discrimination Statement

In accordance with federal civil rights law and U.S. Department of Agriculture (USDA) civil rights regulations and policies, this institution is prohibited from discriminating on the basis of race, color, national origin, sex (including gender identity and sexual orientation), disability, age, or reprisal or retaliation for prior civil rights activity.

Program information may be made available in languages other than English.  Persons with disabilites who require alternative means of communication to obtain program information (e.g., Braille, large print, audiotape, American Sign Language), should contact the responsible state or local agency that administers the program or USDA’s TARGET Center at (202) 720-2600 (voice and TTY) or contact USDA through the Federal Relay Service at (800) 877-8339.

To file a program discrimination complaint, a Complainant should complete a Form AD-3027, USDA Program Discrimation Complaint Form which can be obtained online at:, from any USDA office, by calling (866) 632-9992, or by writing a letter addressed to USDA.  The letter must contain the complainant’s name, address, telephone number, and written description of the alleged discriminatory action in sufficient detail to inform the Assistant Secretary for Civil Rights (ASCR) about the nature and date of an alleged civil rights violation.  The completed AD-3027 form or letter must be sumitted 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; or
  2. Fax:  (833) 256-1665 or (202) 690-7442
  3. Email:

This institution is an equal opportunity provider.