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CACFP Forms

Forms and completed sample forms for use by Child and Adult Care Food Program (CACFP) sponsors.

Eligibility Materials

Adult Component Eligibility Materials
Participant eligibility materials for the adult component of the Child and Adult Care Food Program (CACFP).

Child Care Center Eligibility Materials
Participant eligibility materials for the child care component of the CACFP.

Day Care Home Eligibility Materials
Provider and participant eligibility materials for the day care home component of the CACFP.

Forms

Medical Statement to Request Special Meals and/or Accommodations (DOC)
CNP 925 - This form is used by parents/guardians to have a medical authority prescribe special meals or accommodations during meals.
Available translations of the Medical Statement to Request Special Meals and/or Accommodations for Child Nutrition Programs (Dated Aug-2017)

Parental Request for a Fluid Milk Substitution for Children in Child Care (DOC)
Used by parents to request a fluid milk substitute due to a medical or other special dietary need; see MB USDA-CACFP-09-2017 for more information.

Questions:   Nutrition Services Division | 800-952-5609
Last Reviewed: Wednesday, November 15, 2017