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Get Alaska Wic Breast Pump App Form
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How to fill out the Alaska WIC Breast Pump App Form online
This guide provides step-by-step instructions for filling out the Alaska WIC Breast Pump App Form online, ensuring a smooth application process. By following these instructions, you can easily provide the necessary information to support your infant's needs.
Follow the steps to complete the Alaska WIC Breast Pump App Form online.
- Click ‘Get Form’ button to access the document and open it for editing.
- Fill in the WIC Clinic name where you are participating in the program.
- Enter the date in the provided field.
- Provide your Social Security number.
- Input your infant’s date of birth.
- Fill in your name, including first and last name, along with your email address.
- Complete the mailing address section with the relevant address, city, and zip code.
- Fill in your residence address with city and zip code.
- Provide your home phone number, cell phone number, and work phone number.
- Include the name and email address of an additional contact person, their mailing address, and phone numbers.
- Indicate the breast pump you are being issued by entering the serial number or state tag number for the chosen pump.
- Select the reason for pump issuance by checking the appropriate box.
- Acknowledge your understanding of the instructions for operating the breast pump by checking the appropriate boxes.
- Sign and date the form to finalize your application.
- Once all entries are complete, save changes, and download, print, or share the form as needed.
Complete your application for the Alaska WIC Breast Pump App Form online today!
Yes, WIC provides baby formula to eligible families in Alaska. This support is designed for infants who are not breastfed and ensures they receive the necessary nutrients for healthy growth. If you need more information or assistance, the Alaska WIC Breast Pump App Form can guide you through the process of accessing formula and other resources.
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