Form for requesting Residence Hall Sick Tray

Students who are ill and have a Sodexo meal plan through Drake can request a sick tray by completing the form below.

Ill students who reside on campus in residence halls should complete the form and then contact their RA, Residence Hall Coordinator, Assistant Director of Residence Life or designee to coordinate the pickup of a sick tray meal. If possible, please call Sodexo dining services in advance at 515-271-2777 to have a sick tray meal prepared for pick up.

An off-campus resident with a Sodexo meal plan should complete the form and give it to a representative who will present the form along with the ill resident's Drake Student ID.  This will allow the representative to obtain a meal for the ill resident. If possible, please call Sodexo dining services in advance at 515-271-2777 to have a sick tray meal prepared for pick up.

Residence Hall Sick Tray Request Form

Please allow _______________________________ to use the following my meal card to pick up an ill student meal for me. I have a medical reason for not being able to come to the dining hall and purchase a meal for myself.  

An ill student meal may include:

• Breakfast: Toast, apple juice, bottled water, rice cereal, apple sauce, banana.
•  
• Lunch or Dinner: A bowl of soup, crackers, jello, apple sauce, banana, apple juice, 7 Up or Sprite, and bottled water.

Please note that I have the following food allergies:
______________________________________________________________________________________________________________________

Thank you.

Student Name:_______________________    ID# ______________

Date(s) authorized:___________________________________________

Student Signature: __________________________    Date: _____________

 

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