Get the free Medical Documentation for WIC Formula and Authorized WIC Foods

This form is used to document the medical eligibility of WIC clients, ensuring they have a qualifying condition for the use of WIC formula and foods.

How to fill out medical documentation for wic

How to fill out Medical Documentation for WIC Formula and Authorized WIC Foods

1. Begin by gathering necessary personal information of the applicant, including name, address, and contact details.
2. Fill out the patient's medical history, including any relevant health conditions or allergies.
3. Indicate the specific WIC formula that is being recommended or required for the applicant.
4. Clearly state the reasons for the medical need for the formula and how it supports the individual's dietary requirements.
5. Include the authorized WIC foods that are appropriate for the applicant's nutritional needs.
6. Sign and date the documentation, ensuring that all required signatures from health professionals are included.
7. Review the completed document for accuracy before submission to the WIC program.

Who needs Medical Documentation for WIC Formula and Authorized WIC Foods?

1. Individuals who are infants or young children requiring specialized nutritional support due to medical conditions.
2. Pregnant or breastfeeding women who need specific dietary support and nutrition.
3. Individuals with certain health issues that necessitate the use of specialized WIC formula or foods.

People Also Ask about

Why is Enfamil being discontinued?

Enfamil Newborn is discontinued since newer Enfamil products for infants have replaced it. There were also safety concerns regarding the product when an infant died in 2011, leading certain stores like Walmart to remove it from their shelves. And now, there are doubts about the brand's safety in general.

Is baby formula free with WIC?

WIC will usually cover specialty formulas as long as they are under the brand umbrella for whatever brand the state contracts with. If your state covers Similac and Enfamil, they should cover Alimentum or Nutramigen with a prescription from the doc.

Why did WIC change from Gerber to Similac?

All WIC programs in the US are required to have a formula contract in place for cost containment purposes. Infants previously receiving standard Gerber brand formula benefits will automatically be changed to the most comparable Similac brand infant formula beginning in October.

Does WIC only cover certain brands of formula?

Why does the WIC program only offer certain brands of formula? The WIC program is required to have a contract with a specific formula company to help keep costs down. There are separate contracts for milk-based and soy-based formulas. We renew these contracts every five years.

Why does WIC only give Enfamil?

Formulas Available from California WIC How to Prepare Formula. Always follow proper formula instructions when mixing a bottle for your baby. Similac Advance. 12.4 oz Powder. Similac Advance. 13 oz Concentrate. Similac Sensitive. 12.5 oz Powder. Similac Total Comfort. 12.6 oz Powder. Enfamil ProSobee. Enfamil ProSobee.

For pdfFiller’s FAQs

What is Medical Documentation for WIC Formula and Authorized WIC Foods?

Medical Documentation for WIC Formula and Authorized WIC Foods refers to the required health assessments and recommendations provided by a qualified healthcare professional to certify that a participant is eligible to receive specific WIC-approved formulas and foods based on their medical needs.

Who is required to file Medical Documentation for WIC Formula and Authorized WIC Foods?

Parents or guardians of WIC participants who require specialized formulas or foods due to medical conditions are required to file Medical Documentation. Additionally, healthcare providers must submit this documentation to support the need for specific WIC benefits.

How to fill out Medical Documentation for WIC Formula and Authorized WIC Foods?

To fill out Medical Documentation for WIC Formula and Authorized WIC Foods, complete the necessary forms provided by WIC, ensuring that a healthcare professional specifies the medical condition, the recommended formula or foods, and any relevant dietary instructions. Ensure the documentation is signed and dated by the healthcare provider.

What is the purpose of Medical Documentation for WIC Formula and Authorized WIC Foods?

The purpose of Medical Documentation for WIC Formula and Authorized WIC Foods is to validate the medical necessity for specialized foods and formulas provided under the WIC program, ensuring that participants receive appropriate nutrition tailored to their health needs.

What information must be reported on Medical Documentation for WIC Formula and Authorized WIC Foods?

The information that must be reported includes the participant's medical diagnosis, the specific WIC formula or foods required, any dietary restrictions, the duration of the recommendation, and the signature and contact information of the healthcare provider.