Get the free WIC Food Exemption Request Form - dhss alaska

This form is used by vendors to request exemptions from stocking certain WIC food items due to various reasons such as limited client use or expiration date constraints.

How to fill out wic food exemption request

How to fill out WIC Food Exemption Request Form

1. Obtain the WIC Food Exemption Request Form from your state WIC agency's website or office.
2. Fill in the required personal information, including your name, address, and WIC ID number.
3. Provide details about the specific food items you are requesting to be exempted.
4. Include any relevant medical documentation or statements from a healthcare provider supporting your request.
5. Review your application for completeness and accuracy.
6. Sign and date the form.
7. Submit the completed form to your local WIC office either by mail, email, or in person.

Who needs WIC Food Exemption Request Form?

1. Individuals who are participating in the WIC program and have specific medical or dietary needs that cannot be met by the regular WIC food options.
2. Parents or guardians of children enrolled in WIC who need to request exemptions for their child's dietary restrictions.
3. Healthcare providers who advocate for their patients to receive specific food exemptions due to health concerns.

People Also Ask about

Will WIC reimburse me for formula?

For women who do not fully breastfeed, WIC provides iron-fortified infant formula. Special infant formulas and medical foods may be provided when prescribed by a physician for a specified medical condition.

What does RTU mean for WIC?

Enfamil NeuroPro Gentlease Ready-to-Use (RTU) has been added as a temporary option for WIC participants. Participants will be required to contact their WIC agency for a package change to be able to purchase the RTU product.

What does WIC cover in TN?

Potatoes are approved and garlic is not. All produce is authorized except herbs, spices, garlic, and ginger. WIC also does not authorize produce from salad bars or party trays with dips or other non-produce foods.

What is the WIC exempt formula?

An exempt infant formula is an infant formula intended for commercial or charitable distribution that is represented and labeled for use by infants who have inborn errors of metabolism or low birth weight, or who otherwise have unusual medical or dietary problems (21 CFR 107.3).

What does exempt formula mean WIC?

An exempt infant formula is an infant formula labeled for use by infants who have inborn errors of metabolism or low birth weight, or who otherwise have unusual medical or dietary problems (21 CFR 107.3).

What are exempt formulas FDA?

An "exempt infant formula" is "any infant formula which is represented and labeled for use by an infant who has an inborn error of metabolism or low birth weight, or who otherwise has an unusual medical or dietary problem" (FFDCA 412(h)(1).

Can you get potatoes with WIC?

“The cutoff age of five for WIC is associated with an assumption that this is the normal age at which children enter kindergarten and become eligible for free and reduced price lunch programs,” says Irma Arteaga, assistant professor in the University of Missouri's Truman School of Public Affairs and lead author of the

For pdfFiller’s FAQs

What is WIC Food Exemption Request Form?

The WIC Food Exemption Request Form is a document used by vendors in the Women, Infants, and Children (WIC) program to request exemptions for specific foods or products from the WIC-approved food list.

Who is required to file WIC Food Exemption Request Form?

Vendors who wish to sell or provide foods that are not included in the WIC-approved food list must file the WIC Food Exemption Request Form.

How to fill out WIC Food Exemption Request Form?

To fill out the WIC Food Exemption Request Form, vendors should provide details about the food item, including its description, brand, and reason for the exemption request. They must also include their contact information and any documentation supporting the request.

What is the purpose of WIC Food Exemption Request Form?

The purpose of the WIC Food Exemption Request Form is to allow vendors to seek approval for selling specific food items that are not currently on the WIC-approved list, ensuring that participants have access to a wider variety of healthy foods.

What information must be reported on WIC Food Exemption Request Form?

The WIC Food Exemption Request Form must include the food item's name, brand, nutritional information, the reason for the exemption, the vendor's contact information, and any supporting documents related to the request.