Date: __________________
Dear __________________________________,
___________________________________________________ is a patient of mine who has been diagnosed with celiac disease.
The only known treatment for celiac disease is a gluten‐free diet. The gluten‐free diet is 100% elimination of the protein found in wheat,
rye, and barley from one’s diet.
Please take this into account when reviewing reasonable accommodations for this student.
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Physician Signature
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Physician Contact
National Foundation for Celiac Awareness ⎢P.O. Box 544, Ambler, PA 19002 ⎢ 215‐325‐1306 www.CeliacCentral.org ⎢ [email protected]