PROVIDERS
WIC is a federally-funded health and nutrition program for women, infants, and children. WIC helps families by providing checks for buying healthy supplemental foods from WIC-authorized vendors, nutrition education, and help finding healthcare and other community services. Participants must meet income guidelines and be pregnant women, new mothers, infants or children under age five.
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Program:
WIC Forms:
If writing a prescription for a special formula, please include:
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Patient information
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Type of formula
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Quantity of formula
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Duration of formula
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Medical reason for prescription
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Provider signature and information