If the maximum amount approved (32 ounces) is marked, then the participant will not need to request another form to be filled out by the medical provider if the need for formula increases. Marking an incorrect amount of formula.This describes the reason the change in food or formula is needed. The WIC Formula and Food Authorization Form must have a diagnosis checked by the prescribing authority. These milks can be supplied at the request of the participant or guardian. Do I need a FAFAF for goat milk or soy milk or lactose free milk?.At this time, the USDA has not approved coconut, almond or rice milk for WIC benefits.Can I get coconut milk, rice or almond milk with a FAFAF?.If your doctor recommends one of these supplements for yourself or your child, please feel free to contact a WIC nutritionist so that the FAFAF can be completed correctly. Following the age of 2, and for women, whole milk can only be prescribed along with a medical supplemental food such as Pediasure, Ensure, or Carnation Instant Breakfast.
Children up to the age of 2 automatically receive whole milk from WIC unless a specific request is made by the child’s guardian.All other WIC foods are supplied by means of monthly benefits loaded on your eWIC card which can be used at many major supermarkets around the state. Some formula and medical foods for infants and toddlers must be ordered through a special pharmacy and picked up monthly at the WIC clinic.What about foods that are not found in the store?.Infants whose sole source of nutrition is formula because of tube feeding or similar medical issues may receive more formula if the doctor marks no baby foods and no infant cereal on the FAFAF. Infants who are able to take food by mouth will not receive more formula than the 32 ounces per day maximum provided by WIC.Can I get more formula if my doctor marks “no baby foods”?.If your doctor marks less than this amount, you will not be able to receive more than your doctor has marked. If your doctor marks 32 ounces on the WIC form, you can adjust the amount up to this quantity by talking to your WIC nutritionist. The maximum amount of formula that WIC can provide is 32 ounces per day.What amount of formula or food should my doctor write in?.Please contact your WIC clinic to see if it is available in your language. This form is available in multiple languages.Contact us for details about what needs to be filled out by telephone 80 or text 38. If your doctor has told you that you cannot bring your infant or child into the WIC clinic for their application appointment, your doctor will need to complete this form and fax it to the WIC clinic or you can bring it with you for the appointment.Referral-Data-Form Download Health Data Referral Form
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