Northwest Nutrition Service Forms for Downloading

Northwest Nutrition Service
Forms for Downloading

Forms are available in the Adobe Acrobat PDF format. This requires your computer to have the Adobe Acrobat Reader installed. If you don't have it, you can get it FREE. CLICK HERE and you will go the the ADOBE web site where you will have downloading and installation instructions.

Meal Count Records: A form used to record meals served to day care children that a provider wishes to claim for reimbursement.
DOWNLOAD the Meal Count Records Form for Master Menu Users
DOWNLOAD the Meal Count Records Form for Daily Menu Users

Menu Form: Back page of meal count records form. Form used to record foods that a provider wishes to claim for reimbursement. (For children over one year old)
DOWNLOAD the Menu Form

DHS Meal Count Records: A form used to record meals served a to day care children that a provider wishes to claim for reimbursement for DHS providers.
DOWNLOAD the DHS Meal Count Records Form

DHS Menu Form: Back page of meal count records form. Form used to record foods that an DHS provider wishes to claim for reimbursement. (For children over one year old)
DOWNLOAD the DHS Menu Form

Infant Menu Form Packet: Instruction sheet, Infant Enrollment form, and two copies of the Infant Feeding Benefit Notification and Acknowledgement form.
DOWNLOAD the Infant Menu Form Packet

Infant Menu Form (For Children under one year old)
DOWNLOAD the Infant Menu Form

Enrollment Form: Enrollment of a child (or children from the same family) into the child care food program.
DOWNLOAD the Enrollment Form

DHS Enrollment Form: Enrollment of a child (or children from the same family) into the child care food program.
DOWNLOAD the DHS Enrollment Form

Child Attendance IN/OUT log sheet: Maintaining accurate time in/out forms is mandatory. This is a "sample" you can use.
DOWNLOAD the Child Attendance IN/OUT log sheet

Holiday Verification Form: This form must be completed for each child and turned in with your menus if you provide day care on a state/federal or school holiday.
DOWNLOAD the Holiday Verification Form

Food Allergy Form: To record childrens special allergy restrictions and requirements.
DOWNLOAD the Allergy Form

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Northwest Nutrition Service, PO Box 68365, Milwaukie, Oregon 97268