Medical documents pdf 2026

1. Click ‘Get Form’ to open the medical documents PDF in the editor.
2. Begin with Section A, 'Patient Information.' Enter the patient's name and date of birth accurately to ensure proper identification.
3. Move to Section B for 'Exempt Formula and WIC Supplemental Foods.' Specify the formula requested, length of use, and prescribed amount in ounces per day. Include any special instructions or comments as needed.
4. In Section C, check the appropriate boxes for soy beverage or tofu if applicable for milk protein allergy diagnosis.
5. Complete Section D by providing your signature, date, and contact information as the health care provider.
6. Finally, ensure that Sections E and F are filled out by the participant/parent/caregiver and WIC staff respectively before submission.

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