Get Tn Wic Form

Filling out the Tn Wic Form online can seem daunting, but with clear instructions, you can complete it efficiently. This guide will walk you through each section of the form to ensure all necessary information is provided accurately.

Follow the steps to complete the Tn Wic Form online.

1. Press the 'Get Form' button to access the Tn Wic Form and open it in your preferred online editor.
2. Begin by entering the patient's name in the designated field. Ensure that the name is spelled correctly to avoid processing issues.
3. Input the date of birth in the specified area. Use the format MM/DD/YYYY for clarity.
4. In the 'Request for Alternate Contract Formula' section, check the appropriate boxes for any alternate formulas requested based on the child's needs, such as lactose sensitivity or digestive issues.
5. Specify the formula amount needed per day, keeping in mind the maximum provided is approximately 26 ounces per day unless otherwise indicated.
6. Indicate the number of months for which the issuance is requested, with a maximum of 12 months until the child reaches one year of age.
7. In the 'WIC Supplemental Foods' section, review the list of appropriate foods. If there are any foods that should not be provided, check the corresponding 'DO NOT GIVE' boxes.
8. Complete the Health Care Provider (HCP) Information section. The HCP must provide their signature, attest to the need for the requested formula, and fill in their name, contact phone, fax number, and address.
9. Once all fields are filled out accurately, review the form for errors. Make any necessary corrections.
10. Finalize your entry by saving changes, downloading a copy for your records, or printing the completed form as needed. You may also choose to share it electronically if required.

Complete your Tn Wic Form online today for quick and efficient processing.