Icd 10 code and or medical diagnosis federal regulations prevent formula issuance solely for enhancing nutrient intake or managing body weight with no underlying condition.
Wic approved baby formula alabama.
Date participant s name date of birth.
Some of these formulas require a medical prescription as well as approval by the state or local agency wic program.
Infant formula medical foods information federal regulations for the wic program define minimum requirements for wic eligible infant formula.
This state must use these requirements when creating the alabama wic food list.
To find your local clinic or to learn more about the wic program download our free alabama wic app in your app store call 1 888 942 4673 or e mail wic adph state al us.
Fruit and vegetable juices.
O wic will provide the maximum amount of the alternate similac formula according to infant category and breastfeeding status until the infant reaches 1 year of age.
Mississippi wic approved foods.
The following foods must comply with the fda standards of identity.
When you go shopping at a grocery store remember to bring your wic id folder along with your checks vouchers or your ewic card depending on what the state gives you.
Medical documentation includes an appropriate qualifying medical condition medical reason for the formula quantity ounces day length of use and food restrictions.
All flavors are approved for nys wic eligible formula products.
Alabama wic is still open for business and has modified services throughout the state to help keep wic families and staff safe.
The need for ready to use formula will be addressed by the wic program.
Prescription is subject to wic approval based on program policy.
Other infant formulas may be available based on individual need.
I infant less than 1 year.
Alabama wic infant formula prescription adph wic 111a instructions for completion of form important only this form will be accepted by wic clinics for special formula requests date.
Enter date form is being completed.
The items that fall within the wic food guide are included in this list because they are regarded as economical healthy food items.
Alabama wic child woman formula prescription.
Canned frozen fruits and vegetables.
Below is a list of mississippi wic approved foods.
State wic agencies are then responsible for identifying the types and brands of infant formulas for use in their wic programs.
Enter name of the infant requiring the non contract formula.
Pregnant women postpartum mothers and early age children are at critical development stages in their lives.
O if the infant can t tolerate baby foods between 6 12 months of age wic can provide additional formula in lieu of baby foods if the infant has a qualifying medical diagnosis.
Revised october 2012 wic eligible formulas policy.
