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Minnesota WIC Formula Summary Effective April 2014 MN WIC Contract Formula(WIC Formula Contract is only for standard, routine milk based and soy based infant formula)Primary Contract Formulas(No
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How to fill out minnesota wic formula summary

01
To fill out Minnesota WIC Formula Summary, follow these steps:
02
Start by downloading the Minnesota WIC Formula Summary form from the official website or request a copy from your local WIC office.
03
Begin the form by entering the participant's name, address, and contact information.
04
Provide the participant's WIC ID number and the date of birth.
05
Next, record the participant's assigned WIC food package (e.g., Infants 0-3 months, Infants 4-5 months, etc.).
06
Enter the specific formula brand and size that the participant has been prescribed.
07
Indicate the number of cans or boxes of formula authorized per month.
08
Calculate the total number of units authorized per month based on the formula brand and size.
09
Write down any special instructions or notes related to the participant's formula prescription, if applicable.
10
Finally, sign and date the form, and make a copy for your records before submitting it to the WIC office.

Who needs minnesota wic formula summary?

01
Minnesota WIC Formula Summary is needed by participants of the Minnesota WIC Program who receive formula benefits.
02
This form is used to document the type, brand, and quantity of formula prescribed to WIC participants, ensuring they receive the correct formula as part of their nutritional assistance.
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Minnesota WIC formula summary is a report that outlines the formula used for calculating benefits under the Women, Infants, and Children (WIC) program in Minnesota.
Authorized WIC vendors in Minnesota are required to file the WIC formula summary.
To fill out the Minnesota WIC formula summary, vendors need to accurately report the formula used to calculate WIC benefits.
The purpose of the Minnesota WIC formula summary is to ensure transparency and accuracy in the calculation of benefits under the WIC program.
The Minnesota WIC formula summary must include details of the formula used to determine WIC benefits for participants.
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