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P&P 7.08 Attachment 2 June 9, 2014 Pennsylvania WIC PROGRAM Formula Authorization Form Clients First & Last Name Birth Date Parent/Caregiver 's First & Last Name 1. Formula/Fortifier Requested.

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The WIC Program has entered into a contract with Abbott Laboratories to be the primary provider of infant formula for the WIC Program. The contract brand of infant formula is Similac Advance and Similac Soy Isomil.

For questions about your WIC food benefits, please contact your WIC clinic. For questions about your Oregon eWIC card, please log on to www.ebtedge.com or call eWIC Customer Service at 1-844-234-4946. Your benefits become available on the first day of the month at 12:01 am Pacific Time.

As a result of a contract entered into for a WIC infant formula cost savings initiative, infant formula purchased by WIC customers will be primarily Similac Products; specifically Similac Advance and Similac Soy Isomil. Other brands of infant formula may be prescribed for WIC customers by their physicians.

You can get your food balance by checking your last store receipt, using the balance inquiry terminal at the store, at the Current and Future Balance tab on this website, or calling Customer Service at 1-844-540-3013.

What is eWIC? EBT stands for Electronic Benefits Transfer. WIC EBT is an electronic process where the food benefits are automatically added onto a card, similar to a debit card. This card, which will be known as the eWIC card, replaces the current paper vouchers/checks.

Can I use my WIC card to place an online or delivery order of WIC foods? No. The websites that allow customers to order groceries online are unable to accept WIC cards as a form of payment.

standard infant formulas such as Enfamil Premium Newborn, Enfamil Premium Infant, Similac Isomil Soy, or Good Start products. Specialized formulas may be provided, when appropriate, regardless of manufacturer. (MD/DO/CNM/CNP/PA with prescriptive authority signature required.)

For women who do not fully breastfeed, WIC provides iron-fortified infant formula. Special infant formulas and medical foods may be provided when prescribed by a physician for a specified medical condition.

Before any foods are scanned, tell the cashier you are using an eWIC card. Insert your card into the card reader and follow the directions. The system will ask you to enter your PIN. The cashier scans items to confirm they are WIC approved and are included within your family's benefits.

How often? Some WIC visits will be once a month. Other WIC visits will be 2 months or even 3 months after your last visit if you meet certain requirements. At certain times WIC will ask you to show proof of your income and proof of where you live, and bring medical information from your doctor.

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Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
All Forms
Search all Forms
Industries
Forms in Spanish
Localized Forms
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232