Get Wic Forms Printable

The WIC Forms Printable is an essential document used for enrolling infants and children in the WIC program. This guide will provide you with detailed instructions on how to complete each section of the form online, ensuring a smooth and efficient submission process.

Follow the steps to successfully complete the WIC Forms Printable online.

1. Click ‘Get Form’ button to obtain the WIC Forms Printable and open it in the editing tool.
2. Begin by entering the child's last name followed by their first name in the designated fields.
3. Fill in the parent or caretaker’s name and address, including street, apartment number, city, and zip code.
4. Indicate whether the child has been on WIC before by selecting 'Yes' or 'No'.
5. Provide the child's date of birth, gender, and the languages spoken at home.
6. In the authorization section, fill in the health care provider’s name and sign to allow information sharing with the WIC Program.
7. The healthcare provider should complete the birth history, including birth weight, current weight, height, and gestational weeks.
8. Fill in the hematology section by reporting measurement dates and results for hemoglobin, hematocrit, and blood lead levels.
9. Document immunization dates or attach a copy of the immunization record.
10. In the specific medical diagnosis section, include any relevant diagnoses or health risks along with the ICD-9 code.
11. Finally, the health care provider should print their name, sign the form, and complete the contact information.
12. After filling out the form, ensure all information is accurate before saving changes, downloading, printing, or sharing the completed form.

Complete your WIC Forms Printable online today to ensure timely enrollment in the program.