Special Dietary Needs – Self-identification Form

Yale Hospitality’s program to support students and guests with special dietary needs (e.g., food allergies or intolerance or medical conditions such as celiac, Crohn’s disease or IBS) is based on shared information and a close working relationship between our guests, our managers and our culinary teams. To best assist you in eating well and safely in our dining halls, we ask that you please fill out this form. Please understand that filling out this information is voluntary. The information you provide will be shared with the Resource Office on Disabilities, Yale Hospitality administration and your dining hall manager. They will keep this information confidential.
University Afiliation
Which of the following are you allergic to, and how is your allergy triggered? (check all that apply)
Medical condition not listed on this form:

Form Submission

By submitting this form you authorize the Resource Office on Disabilities and/or Yale Hospitality to contact your residential college head or dean.