Get Florida Department Of Health Wic Program Medical Documentation...

Filling out the Florida Department of Health WIC Program Medical Documentation is an essential step in ensuring that individuals receive the appropriate nutrition support. This guide provides clear, step-by-step instruction on completing the form online, helping users navigate the process effectively.

Follow the steps to complete the WIC Program medical documentation form

1. Press the ‘Get Form’ button to access the medical documentation form and open it in your preferred editor.
2. Begin by entering the client's name and date of birth in the designated fields. Ensure the information is accurate as it is crucial for processing.
3. In the section for formulas and food options, read the guidance provided at the back of the form regarding eligible medical conditions. Indicate whether the WIC contract formulas have been tried and if they are contraindicated by checking 'Yes' or 'No' as appropriate, while providing an explanation.
4. List the desired formula names and indicate either the maximum amount allowed or the specific daily ounces required for each one.
5. If applicable, specify any additional instructions regarding WIC supplemental foods or indicate if only formula is to be issued.
6. Include any special instructions or restrictions that may apply and note the length of use for the requested formula.
7. Document the qualifying medical condition(s) that necessitate the request for special formulas, ensuring to include relevant details.
8. Record the date when anthropometric data were obtained, along with the height/length and weight measurements of the client.
9. Complete any additional sections for milk substitutes only if relevant, indicating the type of milk requested for the individual.
10. Ensure to include the healthcare provider's information by printing their name, phone number, and obtaining the appropriate signature and date.
11. Review the filled-out form for accuracy and completeness. Once finalized, save changes, then download, print, or share as required.

Start filling out your WIC Program medical documentation form online today to ensure timely processing.