This form may be used to refer patients to the WIC Program and to communicate changes in patient health information. The information provided on this form will be used by a WIC nutritionist to determine nutrition care and provide nutrition counseling. A separate form is …

Instructions and Resources for WIC Medical Documentation Form Federal policy limits the issuance of certain formulas to medically fragile participants with qualifying medical conditions.

Learn how to apply for the WIC Program, or contact your local WIC office to schedule your first appointment. Need to check your benefit balance? Visit the WIC Connect portal or call the eWIC card customer service line at 1-844-540-3013. Interested in re-applying for WIC benefits?

Oct 11, 2024 · WIC helps low-income women and their children buy food. You’ll get an eWIC card for buying food. You’ll also get access to services like nutrition counseling, breastfeeding support, health education, and referrals to other programs.

Many of the forms you need to help speed up the New York WIC application process are right here. Click on any of the links below to open or download the form you need.

This form may be used to refer patients to the WIC Program and to communicate changes. in patient health information. The information provided on this form will be used by a WIC. nutritionist to determine nutrition care and provide nutrition counseling. A separate form is required for each patient. Sections B, C and D must be completed by a.

Instructions: Print all appropriate forms and send to: Warren County WIC 1340 State Route 9 Lake George, NY 12845 You can also bring completed copies of the forms with you to your appointment. If you have any questions, please call us at (518) 761-6425. Evening and lunch time appointments are available for working families. Women Medical ...

The NYS WIC Medical Documentation Form designates which sections the health care provider completes and clarifies each section on the reverse side. This guidance and form are available at: www.health.ny.gov/prevention/ nutrition/wic/info_for_health_care_providers.htm.

This form may be used to refer patients to the WIC Program and to communicate changes in patient health information. The information provided on this form will be used by a WIC nutritionist to determine nutrition care and provide nutrition counseling.

The Special Supplemental Nutrition Program that provides nutrition counseling, breastfeeding support, and an eWIC debit card to purchase nutritious foods for eligible Women, Infants, and Children (WIC).