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Medical Diagnosis Check all that apply Allergies Cystic fibrosis GERD FTT Feeding Difficulties Malnutrition C. Authority. Utah WIC Rebate Formulas Issuing the following contract formula doesn t require the use of this form and will be more cost effective allowing the Utah WIC Program to serve more participants Similac Advance Gerber Good Start Soy Gerber Graduates Soy The following formulas must be ordered by the health care provider using this form and will still result in a rebate Similac...
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Infants up to 12 refer to children who are under 1 year old to 12 years old.
Parents or legal guardians of infants up to 12 are required to file relevant information.
You can fill out infants up to 12 by providing necessary details such as name, age, medical history, and any other relevant information.
The purpose of infants up to 12 is to ensure proper care, monitoring, and support for children in their early years.
Information such as health records, vaccinations, growth development, and any specific needs must be reported on infants up to 12.
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