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                Get Texas Wic Form
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How to fill out the Texas WIC Form online
Filling out the Texas WIC Medical Request for Formula/Food form online can be a straightforward process. This guide provides clear, step-by-step instructions to assist users in completing the form accurately and efficiently.
Follow the steps to complete the Texas WIC Form online
- Click ‘Get Form’ button to access the Texas WIC form and open it in an online editor.
- In section A, provide the required patient information. Fill in the patient’s last name and first name, followed by their date of birth. Next, include the name of the parent or caregiver and specify the qualifying condition or diagnosis. Refer to the reverse side of the form for examples of qualifying conditions.
- Enter the patient's measurements in the same section, including the date of measurement, length or height, weight, and if applicable, the birth weight and weeks of gestation for premature infants.
- In section B, list the name of the requested formula(s) and indicate the desired length of issuance (3 months, 6 months, or other). Specify the formula amount per day, noting that the maximum allowed by federal guidelines will be provided unless stated otherwise.
- If requesting a trial of a contract formula for infants, indicate the reason for the trial under the appropriate section. Fill out any necessary details if applicable.
- Complete section C only if requesting soy packages for children. Specify the type of soy product requested and any other medical reasons.
- Move to section D, where the health care provider must provide their signature or stamp, including the date, provider’s name (printed), and phone number. This section is crucial for WIC approval.
- Once all relevant sections are filled out, review the information for accuracy. Save changes, and then download, print, or share the completed form as needed.
Complete your Texas WIC Form online today and ensure your healthcare needs are met.
Using WIC in Texas is straightforward once you’ve obtained your benefits. You will receive the Texas WIC Form, which outlines your approved foods. When you shop, you can use your WIC checks or card at participating retailers to buy these items. Always remember to keep your Texas WIC Form handy for quick reference during your purchases.
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