Related links
WIC Medical Documentation
Use this form to request exempt formulas, WIC-eligible nutritionals, higher amount of standard formulas for infants 6 months who are unable to tolerate solid
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WIC Pediatric Referral Form - Provider Library
SECTION I: Complete this section to assist the patient with WIC eligibility, WIC services, and appropriate referrals. Whenever a therapeutic formula is
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IFPS II - Project FIRST Month 5 Questionnaire
Please X the group number for each infant formula your baby was fed. A lactation consultant, WIC staff, nurse, or doctor showed me how to use it.
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