Page 1 is the medical statement and page 2 holds the instructions.
Signature: a Registered Dietitian (RD) or State Licensed Healthcare Professional signs; this form is also considered valid with a certified digital signature.
Healthcare professionals: the CDE permits licensed physicians, physician assistants, and nurse practitioners to complete and sign a medical statement for a disability.
Fluid milk only: parents or legal guardians wishing to request only a fluid milk substitute to accommodate their child's disability should use the CDE's SNP 26 form.
Texture: if the child does not need any modification, check Regular.
| Question | Answer |
|---|---|
| Form Name | CNP-925 |
| Form Length | 4 pages |
| Fillable? | Yes |
| Fillable fields | 30 |
| Avg. time to fill out | 5 min |
| Edition | Rev 3/26 |
| Issuing agency | California Department of Education Nutrition Services Division |
| Other names | CNP-925, CNP 925, CNP925, Form 925, CNP form, Medical Statement to Request Special Meals and/or Accommodations |
| Official source | CNP-925 (Rev. 3/26), California Department of Education Nutrition Services Division |
Form Cnp 925 isn’t the one you’re looking for?