Food Allergy & Special Dietary Form

Please submit completed form at least 3 weeks prior to the first day of scheduled residency.

All late requests will be addressed on a case by case basis. After you fill out this form, a meeting will be offered between you and a member of the Restaurant Operations staff to ensure that your dietary restrictions are fully accommodated. This meeting is strongly encouraged for all participants, but highly recommended for individuals with severe life threatening allergies.

For additional questions or concerns please contact:

Brian Vetter, Assistant Director of Contract Dining at (414) 229-2525

Food Allergy & Special Dietary Form

  • Resident Information

  • (Ex: 2015)

  • Food Allergies / Intolerances / Special Dietary Needs

    Please check ALL that apply
  • You understand that salad bars, fruit bars, bakery, "create your own" stations and similar setups, by its very nature, carries with it certain inherent ingredient cross contaminations risks that cannot be eliminated, regardless of the care taken, because of other customer interactions and ingredient substitutions. All menus/net nutrition program/websites/marketing outlets/signs that contain nutritional symbols and ingredient information are provided for a reference only. Dietary information, including allergen identifiers, can be accessed at the following site: http://uwm.edu/dining/dietary-info/ Items may contain allergen ingredients without prior notice due to manufacturer or unit substitutions. If there are any questions regarding specific menu item ingredient(s), one must consult the onsite manager to ensure that the particular menu item is free of said allergens before consuming.

  • Agreement

  • By clicking the submit button you acknowledge that you have read, understood, and agree with the information presented on this form.