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Montana OPI Medical Statement for Special Meals

Montana schools in the USDA child nutrition programs, including school lunch, breakfast, afterschool snacks and summer meals, use this statement before making meal substitutions for a child with a disability. The provider describes the disability and the major life activity affected, and, if the diet is restricted, lists foods to omit and substitute with a diet plan, texture changes and equipment.

Who completes it

The parent completes the child's details and a HIPAA and FERPA release. A state licensed healthcare provider (physician, nurse practitioner, physician assistant, registered dietitian or mental health provider) completes parts A to F, signs and stamps it.

Submitting and payment

How to submit it
The statement must be completed in its entirety and submitted to the school before any meal substitutions are made.

Good to know

  • A specific diet plan must be provided before school food service can make substitutions. Texture changes list foods to cut into bite-size pieces, finely grind or puree.
  • Parents review the form annually and initial and date it if nothing changed. Any change requires a new statement signed by the provider.
  • The parent's release carries an expiration date, and OPI recommends one year so updates line up with the child's annual physical.
  • A signed statement is needed for reimbursement when meals don't meet the meal pattern. Within-pattern changes don't require one, though schools may ask for it.

Get the official form

Download the current version from the source each time; forms change without notice.

Medical Statement for Children with Disabilities Requiring Meal Accommodations in the USDA Child Nutrition Programs

Official pagePDF

Fill it with Vero

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How this list is checked

A form is listed only after its name and number were confirmed on the issuing agency’s or insurer’s own website, or in the form itself. Each entry links to that source. The list was last checked in October 2026. Forms and their requirements change without notice, so check the official page for the current version before you complete one.

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Frequently asked questions

Who can sign Montana's Medical Statement for Children with Disabilities?

A state licensed healthcare provider. The July 2025 revision names physicians, nurse practitioners, physician assistants, registered dietitians and mental health providers. If the disability restricts the diet, the provider completes parts C to F, then signs and stamps the form with the office name and address.

Does Montana's meal statement need to be renewed every year?

Not necessarily. The parent should review it annually and initial and date it if no changes are needed. Any change to the diet requires a new form signed by the child's state licensed healthcare provider, and OPI recommends the parent's release expire after one year.