Florida Department of Health to partner with Community Hope Center
Florida Wic Form. See instructions for completing this form on the reverse side. Medical documentation for formula and food form 146 kb pdf.
Florida Department of Health to partner with Community Hope Center
Bureau of wic program services. Web to apply for wic: Medical documentation for formula and food form 146 kb pdf. Bureau of wic program services. 4052 bald cypress way, bin a16. Final determination of the approval and provision of formula and food will be based on florida wic program policies and procedures. Web wic is the acronym for the special supplement al nutrition program for women, infants and children. Web contact the florida wic program. Web contact the florida wic program. Form completion is not a confirmation of medicaid approval.
Web the florida wic program supports the american academy of pediatrics’ statement on breastfeeding and the use of human milk. Final determination of the approval and provision of formula and food will be based on florida wic program policies and procedures. The local wic office will give you a date and time for a wic certification visit. Form completion is not a confirmation of medicaid approval. Wic forms including florida wic program medical referral form and medical documentation for formula and food form can be found on the following website: At this visit, the household income and the medical/nutrition status of each applicant will be reviewed. Web contact the florida wic program. Yes no for wic office use only:date of wic certification appointment ______________ Web fax for all wic clinics. Medical documentation for formula and food form 146 kb pdf. Contact your local wic office for wic forms and other materials.
