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MEALTIME MANAGEMENT PLAN

NOTE 1:

Please read the details on this form and check the labels of the meals carefully. Please follow the instructions on the meal label for safe and secure storage. Please report all incidents, issues, and concerns as soon as possible.

NOTE 2:

A copy of this form should be kept by the support worker and another copy should be provided to the participant.

Does Participant has any special personal, cultural or religious food preferences?
Does Participant any food allergies?
Service Start Date
Address

List below the Foods that should not be provided to the participant for any reason such as swallowing difficulties, diabetes, anaphylaxis, food allergies, obesity, and/or being underweight, etc.:

Include any allergies, personal, cultural or religious preferences.