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Get the free WIC 6 DHSS Nutrition & Health Resource Request Form *Limit 50 ... - health mo

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MISSOURI HEPA RECENT OF The LTD AND SENIOR SER VICES WIC A ND NUTRITION SERVE Ancestor WIC Local Agency Use Only Reset Formic 6 DSS Nutrition & Health Resource Request Form AGENCY EMERGENCY / CLINIC
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How to fill out wic 6 dhss nutrition

01
To fill out WIC 6 DHSS nutrition form, follow the steps below:
02
Start by entering your personal information, including your name, address, and contact details.
03
Provide your WIC identification number, which can be found on your WIC eligibility card.
04
Indicate the number of household members for whom you are requesting WIC assistance.
05
Fill out the income section, including your monthly income and the source of your income.
06
Specify the number of individuals in your household who are currently enrolled in Medicaid or food stamps.
07
Answer the questions regarding your household's participation in other nutrition assistance programs.
08
Provide the details of the child or children for whom you are seeking WIC assistance, including their names, birth dates, and any special dietary needs.
09
Complete the nutrition assessment section, answering the questions about your child's overall health, growth, and any nutritional concerns.
10
Finally, review and sign the form, certifying that the information provided is accurate and true to the best of your knowledge.

Who needs wic 6 dhss nutrition?

01
WIC 6 DHSS nutrition form is needed by individuals or households who are seeking assistance from the Women, Infants, and Children (WIC) program.
02
This program provides supplemental nutrition and support to pregnant women, new mothers, and young children who meet certain income and nutritional criteria.
03
Individuals who believe they are eligible for WIC benefits and want to apply for them need to fill out the WIC 6 DHSS nutrition form.
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WIC 6 DHSS Nutrition is a form used to report nutrition information to the Department of Health and Senior Services.
Any organization or individual responsible for providing nutrition services as part of the WIC program is required to file WIC 6 DHSS Nutrition.
WIC 6 DHSS Nutrition can be filled out online or submitted via mail with all the required nutrition information.
The purpose of WIC 6 DHSS Nutrition is to track and monitor the nutritional services provided within the WIC program.
Information such as nutritional assessments, counseling provided, and food package adjustments must be reported on WIC 6 DHSS Nutrition.
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