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Soy Milk Request Notification Form

Thursday, June 22, 2017

To: Parents or guardians of children ages 1 year and older or adult participant

Your care provider participates in the Child and Adult Care Food Program (CACFP). The CACFP is administrated by the District of Columbia Office of the State Superintendent of Education and is funded by the United States Department of Agriculture (USDA).  The CACFP provides reimbursement for healthy meals prepared and served by your provider. Your provider follows the USDA Meal Pattern Requirements and is required to provide specific food groups in specific quantities in order to receive reimbursement for the meals served. The required CACFP food groups are: milk, bread/bread alternate, fruit, vegetable, and meat/meat alternate.

USDA allows providers participating in CACFP to serve approved soy milks in place of cow’s milk at the request of and with written notification from the parent, guardian or adult participant. Providers may also claim reimbursement if the parent, guardian, or adult purchases and provides an approved soy milk along with written notification. Completing this form counts as written notification.

Related Content: CACFP Program Management Forms