Special Diet Verification Form for Students

Special Diet Verification Form for Students

The purpose of this form is:
1. To assist students and customers in meeting their dietary needs and requirements,
2. Verify that the food served conforms to the special dietary need, and
3. Provide information on the students’ responsibilities.

Requests are not complete until supporting documentation (ex. Verification from a Qualified Physician) has been submitted.

Food Allergy Disclaimer
Eastern Illinois University (Panther) Dining Services will make every effort to identify ingredients that may cause allergic reactions for those individuals with food allergies and/or intolerances.

Every effort is made to instruct our food production staff on the severity of food allergies. In addition, we label items with possible allergen-containing ingredients; however, there is always a risk of contamination. There is also a possibility that manufactures of the commercial foods we use could change the formulation at any time, without notice. Customers concerned with food allergies need to be aware of this risk.

Panther Dining Service cannot assume any liability for adverse reactions to food consumed, or items one may come in contact with while eating at any University Dining facility or catered event.

Students with food allergies are encouraged to contact our Graduate Assistant, Amanda Kasper, at aasmith5@eiu.edu for additional information or support.