Texas wic formulary

Texas WIC Formula Request Form (pdf) The following is a list of WIC Offices located throughout Collin County. If you have questions about eligibility or the services offered under the WIC program, please contact the Collin County WIC Office closest to you. Collin County WIC Offices McKinney Office. 825 N. McDonald, Suite 120 McKinney, TX 75069 Map

Calculate how much you'll pay in property taxes on your home, given your location and assessed home value. Compare your rate to the Texas and U.S. average. Calculators Helpful Guid...Page 3 Revised 6/1/2021 TEXAS WIC FORMULARY AND MEDICAL REASONS FOR ISSUANCE June 2021 Formula Category Description Qualifying Conditions Staff Instructions - May issue for 1 cert Manufacturer Name period unless otherwise indicated. Boost Plus Increased 46 cal/oz, lactose-free, high-calorie; 1) Increased calorie needs …The caregiver presents a medical request from the health care professional for a non-contract formula that can be approved and issued per policy FD:16.0. II. Contract soy-based infant formula. a. Issue the contract soy-based infant formula in cases where: The family follows a vegan (vegetarian, no dairy) diet and requires a soy formula or;How to enjoy Texas outdoors in summer. The best swimming and water sports are at natural springs, beaches, outdoor pools, and rivers. Everything is bigger in Texas, including the h...Find the latest Texas WIC formulary and formula approval resources for WIC providers and families. Download PDFs or Excel files of food packages, formula guides, forms and aids, and nutrition assessment requirements. See moreTwo Revised Materials Available: Texas WIC Formula Change Form and Help Your Baby Change to a New Formula. WIC Memo. 21-107. December 1, 2021. 2021. December. WIC. wic-21107.pdf.

WIC Staff are available to assist you Monday through Friday, 8 a.m.-5 p.m. Call toll-free: 800-942-3678. Live Chat with WIC Staff. Text us at 1-855-960-4551. Email WIC [email protected]. Find a WIC office near you. With myWIC you can schedule appointments, upload documents, view the shopping guide, check your benefits and more.Breastfeeding and Formula Feeding. WIC is here to help you meet your breastfeeding goals. Starting or increasing formula can decrease your breastmilk supply. If you need help maintaining your supply, please talk to someone at your local WIC clinic or call the free 24/7 Texas Lactation Support Hotline at 855-550-6667.WIC Services. The Women, Infants & Children (WIC) Program is a federally assistance program administered by the Texas Health and Human Services Commission (HHSC) through a network of over 500 local WIC clinics across the state that provides access to healthy food, nutrition education, and healthcare resources to low-income pregnant …Look through your Texas WIC Shopping Guide to learn which brands and sizes of food you can buy with your Texas WIC Card. . Approved WIC Foods Shopping Guide (English - PDF, 7.3 MB); Approved WIC Foods Shopping Guide (Spanish - PDF, 6.7 MB); Approved WIC Foods Shopping Guide (Vietnamese - PDF, 6.7 MB); Approved …Products prescribed for inborn-errors of metabolism. (e.g., PKU) require a completed Texas WIC Medical Request for Metabolic Formula/Food (stock no, EF-16-03-13158) from a qualified metabolic Center listed on the back of the metabolic prescription form. If center is not listed, contact the SA. The metabolic form is available at.Top 5 Things Moms Love About Texas WIC. Contact Us. Resources. WIC In the News. Apply. ... Formula Prescriptions. Infant Feeding Options. Partner Resources. Texas Ten ...Texas WIC provides benefits for pregnant, breastfeeding and postpartum women and children up to 5 years old. Learn about WIC foods, recipes, classes, online resources and more.See the Texas WIC Formulary for available therapeutic formulas, which require health partners to fill out a Texas WIC Medical Request for Formula/Food Form. WIC approval is required. See the Formula Prescriptions page for …

Check below to request an alternate WIC formula due to formula intolerance: O SimilacSensitive - for lactose sensitivity and/or colic O Similac for Spit Up - for spitting up and/or reflux (Medical Request not required until June 1st, 2014) March 2024. Enfamil Infant. 663 (PWD) 664 (CON) 665 (RTU) Milk-based Infant Formula: 20 cal/oz, milk-based with prebiotic GOS (Galacto-oligosaccharides) and polydextrose (PDX); 60:40 whey-to-casein ratio; not intended for infants or children with galactosemia. Similar to Similac Advance. WIC Texas is a program that provides healthy foods, breastfeeding support, nutrition classes and other resources for pregnant and breastfeeding families. Learn how to apply, get benefits, access online classes, and find local resources on the WIC website.Information for. Families with Formula-Fed Infants. Whether you need to temporarily supplement or prefer to use formula, WIC staff can help you choose which WIC-approved formula is right for your baby. If you are breastfeeding and formula feeding, WIC staff can help you maintain your milk supply and work through any breastfeeding challenges.RX required for contract and non-contract formulas. Higher amount of formula, no foods due to inability to eat solids-e.g., preemie (FD: 16.1) This food package can be issued prior to 6 months when advance issuing. 896 / 460 fl oz reconst conc 913 / 474 oz RTF 960 / 552 oz reconst powder. 34 / 17 cans formula 28 / 14 cans formula # cans powder ...Information for. Families with Formula-Fed Infants. Whether you need to temporarily supplement or prefer to use formula, WIC staff can help you choose which WIC-approved formula is right for your baby. If you are breastfeeding and formula feeding, WIC staff can help you maintain your milk supply and work through any breastfeeding challenges.

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TEXAS WIC FORMULARY AND MEDICAL REASONS FOR ISSUANCE February 2021; Formula Name Category Description; Qualifying Conditions; Staff Instructions - May issue for 1 cert period unless otherwise indicated Manufacturer: Boost Plus Increased Calorie Supplement 46 cal/oz, lactose-free, high-calorie; nutritionally complete; similar to Ensure …Death records are an important part of family history and genealogy research. If you’re looking for Texas death records, there are a few ways to go about it. This article will prov...Formula Recall. There is a recall of Similac, Similac PM 60/40, Alimentum, EleCare and EleCare Jr. powdered formulas. If you use powdered formula, follow these steps: Check to see if your formula has been recalled at similacrecall.com. If recalled, do NOT use it. Return it to the store or call the manufacturer at 800-986-8540 for replacement.A list of approved infant and pediatric formulas for Texas WIC participants with special medical conditions or increased calorie needs. Includes brand names, calorie content, availability, requirements, approval authority, and limitations for each formula.Texas WIC helps you buy the foods that you and your children need to stay healthy. The WIC foods in your monthly food package are low in fat, high in fiber, help you get important nutrients and promote a healthy weight. WIC helps you buy many of the healthy foods already on your grocery list. You will still need to buy some food (or …Breastfeeding and Formula Feeding. WIC is here to help you meet your breastfeeding goals. Starting or increasing formula can decrease your breastmilk supply. If you need help maintaining your supply, please talk to someone at your local WIC clinic or call the free 24/7 Texas Lactation Support Hotline at 855-550-6667.

How to enjoy Texas outdoors in summer. The best swimming and water sports are at natural springs, beaches, outdoor pools, and rivers. Everything is bigger in Texas, including the h... that the reconciliation of cost for the formula is between the grocery store and Reckitt. Texas WIC is ready to assist our vendor partners. For questions regarding this Vendor News Flash, please contact the Vendor Management Unit’s Vendor Outreach Branch at . [email protected] or 1-800-252-9629. Find more WIC vendor resources ... Texas WIC . Health and Human Services Commission . Effective May 1 , 202 3 Policy No. FD:1 6 .1 . FD:16.1 – Issuance of Formula Food Packages and Transfer Scenarios . WIC Policy and Procedures Manual 1 . Issuance of Formula Food Packages and Transfer Scenarios Purpose . To ensure that Texas WIC participants receive the infant formula,Information for. Families with Formula-Fed Infants. Whether you need to temporarily supplement or prefer to use formula, WIC staff can help you choose which WIC-approved formula is right for your baby. If you are breastfeeding and formula feeding, WIC staff can help you maintain your milk supply and work through any breastfeeding challenges.Todo lo que Tienes que Saber Acerca de Comprar con WIC de Texas — Spanish (26:22 min, YouTube) Texas WIC Approved Foods Poster. WIC-34P Texas WIC Approved Foods Poster English (PDF) WIC-34PA Alimentos aprobados de WIC de Texas Spanish (PDF) Texas WIC Shopping Guides. WIC-34 Texas WIC Shopping Guide English (PDF)Death records are an important part of family history and genealogy research. If you’re looking for Texas death records, there are a few ways to go about it. This article will prov...Texas WIC Health and Human Services Commission Effective August 9 , 2022 Policy No. FD:19.0 WIC Policy and Procedures Manual 1 ... Staff must not reissue containers of returned formula to another WIC participant for any reason, except as provided under #7 below. 5. Staff must determine if returned containers are to be donated or disposed.Talk with your WIC nutritionist and use the directions below to help support your baby’s formula change. If you are also breastfeeding your baby, WIC can help you maintain your breastmilk supply while supplementing. Talk to your local WIC office or call the free 24/7 Texas Lactation Support Hotline at 855-550-6667.

Formula Recall. There is a recall of Similac, Similac PM 60/40, Alimentum, EleCare and EleCare Jr. powdered formulas. If you use powdered formula, follow these steps: Check to see if your formula has been recalled at similacrecall.com. If recalled, do NOT use it. Return it to the store or call the manufacturer at 800-986-8540 for replacement.

Vendor Formula Alternatives – October 2022 WIC Standard Product: Similac Soy Isomil PWD 12.4 oz (389) - NTE $22.09 300871214415 ENFAMIL PROSOBEE PWD 12.9OZ. 50000035304 GS GENTLE SOY STAGE 1 PWD 12.9OZ ... Texas, WIC, Vendor, Formula, Alternatives, October, 2022 Created Date:This document lists the approved infant and pediatric formulas for Texas WIC participants, as well as the medical conditions and requirements for issuance. It also includes the product names, types, calorie content, and availability of each formula.In the world of pharmacy management, one crucial aspect is the creation of an effective formulary list. A formulary list is a comprehensive compilation of medications that are appr...WalletHub selected 2023's best home insurance companies in Texas based on user reviews. Compare and find the best home insurance of 2023. WalletHub makes it easy to find the best I...Texas WIC Formulary. Alfamino Infant. 593. Elemental: 20 cal/oz when mixed 1 scoop to 1 oz water; hypoallergenic amino acid based. 43% of fat is MCT oil. Similar to Elecare DHA/ARA, Neocate DHA/ARA and PurAmino. Available in PWD (14.1oz can). Condition that impairs digestion/absorption. 2) GI Disorder.A list of approved infant and pediatric formulas for Texas WIC participants with special medical conditions or increased calorie needs. Includes brand names, calorie content, availability, requirements, approval authority, and limitations for each formula.For more information, contact Kathrine Galvan – WIC Program Director 361-826-1355 or at [email protected]. About Texas WIC. The Special Supplemental Nutrition Program for Women, Infants and Children (WIC), which is administered by Texas HHSC, is a nutrition program for pregnant women, breastfeeding women, and families with children ...More Formula. Full Formula Infant. 1000 Full Formula 0-3 Infant 1001 Full Formula 4-5 Infant 1002 Full Formula 6-11 Infant 1010 Rx More Formula FF 6-11 Infant. Some Breastfeeding Infant. 1003 SBF 0-3 Infant 1004 SBF ... HHSC, Texas, WIC, TXIN, Food, Packages, August, 2021 Created Date:The Texas WIC Program encourages mothers to breastfeed their babies for the first year of life, with the addition of complementary foods around six months. When infant formula is necessary or requested, WIC provides contracted formulas or requires a medical request for therapeutic formulas. All requests are subject to approval and provision ...Texas WIC Medical Request for Therapeutic Formula. The Texas WIC Program encourages mothers to breastfeed their babies for the frst year of life, with the addition of complementary foods around six months. When infant formula is necessary or requested, WIC provides contracted formulas or requires a medical request for therapeutic formulas.

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Texas WIC Formulary - May 2019 Subject: Texas WIC Formulary and Medical Reasons for Issuance - May 2019 Author: Texas WIC Keywords: Texas, WIC, Formulary, Medical Reasons for Issuance, May 2019 Last modified by: Mcclendon Barbra A Created Date: 10/9/2019 11:31:07 AM Other titles:Texas WIC provides benefits for pregnant, breastfeeding and postpartum women and children up to 5 years old. Learn about WIC foods, recipes, classes, online resources and more.TEXAS WIC FORMULARY AND MEDICAL REASONS FOR ISSUANCE October 2022. Formula Name Formula Code Description Qualifying Conditions. Staff Guidance Manufacturer/ Packaging* Alfamino Infant 593. Elemental: 20 cal/oz when mixed 1 scoop to 1 oz water; hypoallergenic amino acid based. 43% of fat is MCTSUBJECT: Formula Approval Resources . The following Formula Approval resources have been updated and are posted as of 8/1/2023. • Texas WIC Formulary • Nutrition Assessment Requirement Guide • Texas WIC Maximum Quantity Table for Infants • Texas WIC Maximum Quantity Table for Women and ChildrenThe Texas WIC Program encourages mothers to breastfeed their babies for the first year of life, with the addition of complementary foods around six months. When infant formula is necessary or requested, WIC provides contracted formulas or requires a medical request for therapeutic formulas. All requests are subject to approval and provision ...Modular: 1 scoop = 1 tablespoon = 8.6 g = 35 cal; 4.1 cal/g; standard serving 2 scoops per 1/2 cup food or water; 40 scoops per can; nutritionally incomplete; macronutrient distribution range per 100 g: 54% carbohydrate, 25% protein, 21% fat; 8% of fat is MCT oil; enriched with L-leucine, 29 vitamins and minerals. Available in PWD (12oz can).Formula Prescriptions. Infant Feeding Options. Partner Resources. ... Call 800-942-3678 to learn more about Texas WIC. Sub Footer. Contact Us; Nondiscrimination ...TEXAS WIC APPROVED FOODS SHOPPING GUIDE Choose Any Brand • 16 to 18 oz. jar • Creamy or crunchy NOT WIC APPROVED: ... Cereal with fruit, formula, DHA, added ingredients, or organic. Exclusively Breastfeeding Infants 6 … ….

Products prescribed for inborn-errors of metabolism. (e.g., PKU) require a completed Texas WIC Medical Request for Metabolic Formula/Food (stock no, EF-16-03-13158) from a qualified metabolic Center listed on the back of the metabolic prescription form. If center is not listed, contact the SA. The metabolic form is available at.Jan 19, 2023 · Alternate Formulas Extended Through February 28. Texas WIC will continue allowing alternative brand formulas through February 28, 2023. WIC participants are being informed that when Enfamil and Similac Soy Isomil formula is unavailable, they may get alternative options. It is very likely February will be the last month that alternative formula ... TEXAS WIC FORMULARY AND MEDICAL REASONS FOR ISSUANCE June 2021 Formula Name Category Description. Qualifying Conditions. Staff Instructions - May issue for 1 cert period unless otherwise indicated Manufacturer. Alfamino Infant Elemental. 20 cal/oz when mixed 1 scoop to 1 ozTEXAS WIC FORMULARY AND MEDICAL REASONS FOR ISSUANCE July 2022. Formula Name Formula Code Description Qualifying Conditions. Staff Guidance Manufacturer/ Packaging* Alfamino Infant 593. Elemental: 20 cal/oz when mixed 1 scoop to 1 oz water; hypoallergenic amino acid based. 43% of fat is MCT TEXAS WIC FORMULARY AND MEDICAL REASONS FOR ISSUANCE February 2020 Formula Name Category Description Qualifying Conditions Staff Instructions - May issue for 1 cert period unless otherwise indicated Manufacturer Alfamino Infant Elemental 20 cal/oz when mixed 1 scoop to 1 oz water; hypoallergenic amino acid based elemental. 43% of fat is MCT Talk with your WIC nutritionist and use the directions below to help support your baby’s formula change. If you are also breastfeeding your baby, WIC can help you maintain your breastmilk supply while supplementing. Talk to your local WIC ofice or call the free 24/7 Texas Lactation Support Hotline at 855-550-6667.The following Formula Approval resources have been updated, effective 2/5/2021 and are attached. • Formula Code List • Formulary • Nutrition Assessment Requirement Guide • Texas WIC Maximum Quantity Table for Infants • Texas WIC Maximum Quantity Table for Women and Children The February updated resources will be available here soon. ...TEXAS WIC FORMULARY AND MEDICAL REASONS FOR ISSUANCE MAY 2019 Formula Name Category Description Qualifying Conditions Staff Instructions - May issue for 1 cert period unless otherwise indicated Manufacturer Alfamino Infant Elemental 20 cal/oz when mixed 1 scoop to 1 oz water; hypoallergenic amino acid based elemental. … Texas wic formulary, On Oct. 1, Texas WIC’s new formula contract went into effect. Texas WIC’s contract for milk-based formulas has switched from Abbott Laboratories, the makers of Similac, to Mead Johnson, the makers of Enfamil products. The new contract is only for milk-based formulas. All other formula products remain unchanged. “All WIC participants …, The Texas WIC Formula Team will provide a lunch-and-learn training on Thursday, August 11th instead of the Q and A for the Contract Formula Transition. If you have any questions or require additional information regarding . Texas WIC Policy FD:19.0 – Managing Returned Formula, please contact Gabrielle Serna, WIC Food and Formula Specialist, at, Modular: 1 scoop = 1 tablespoon = 8.6 g = 35 cal; 4.1 cal/g; standard serving 2 scoops per 1/2 cup food or water; 40 scoops per can; nutritionally incomplete; macronutrient distribution range per 100 g: 54% carbohydrate, 25% protein, 21% fat; 8% of fat is MCT oil; enriched with L-leucine, 29 vitamins and minerals. Available in PWD (12oz can). , WIC Temporary Product: Enfamil NEURO INF PWD 28.3OZ (679) - NTE $50.56 WIC Temporary Product: Enfamil NEURO INF BOX PWD 31.4OZ (680) - NTE $54.10 WIC Temporary Product: ENFAMIL REGULINE PWD 19.5OZ (692) - NTE $41.35 WIC Temporary Product: ENF NEURO INFANT PWD BOX 36.4OZ (697) - NTE $69.72 Generic Hypoallergenic Formula Options - available ..., Texas WIC Formulary - May 2019 Subject: Texas WIC Formulary and Medical Reasons for Issuance - May 2019 Author: Texas WIC Keywords: Texas, WIC, Formulary, Medical Reasons for Issuance, May 2019 Last modified by: Mcclendon Barbra A Created Date: 10/9/2019 11:31:07 AM Other titles:, The Texas WIC Formula Team will provide a lunch-and-learn training on Thursday, August 11th instead of the Q and A for the Contract Formula Transition. If you have any questions or require additional information regarding . Texas WIC Policy FD:19.0 – Managing Returned Formula, please contact Gabrielle Serna, WIC Food and Formula Specialist, at, Formula . No Shading = Issued to Women and Children Only Revised March 2024. TXIN WOMEN AND CHILDREN MAXIMUM FORMULA QUANTITIES TABLE MARCH 2024. Formula . 1. MARCH ... , Feb 5, 2021 ... Real moms, Nayeli and Claire, talk about continuing to add new foods into your baby's diet. Learn about moving from pureed foods to mashed ..., Whether you need to temporarily supplement or prefer to use formula, WIC staff can help you choose which WIC-approved formula is right for your baby. If you are breastfeeding and formula feeding, WIC staff can help you maintain your milk supply and work through any breastfeeding challenges. For 24/7 breastfeeding support, call 855-550-6667., Tesla notified Texas regulators this week it plans to invest about $770 million into an expansion of its Austin factory. Tesla notified Texas regulators this week it plans to inves..., The Texas Longhorns are one of the nation’s most successful college sports organizations. The history of the Texas Longhorns illustrates how today’s college sports programs have be..., Sometimes, a formula cannot be approved or is not available through Texas WIC. If so, clinic staff will call to discuss other options for your patient. e. WIC formula is typically purchased at retail stores. Some specialty items (such as metabolic formulas) are only available through a pharmacy, specialized WIC store, or drop shipment company., Formula Recall. There is a recall of Similac, Similac PM 60/40, Alimentum, EleCare and EleCare Jr. powdered formulas. If you use powdered formula, follow these steps: Check to see if your formula has been recalled at similacrecall.com. If recalled, do NOT use it. Return it to the store or call the manufacturer at 800-986-8540 for replacement., RX required for contract and non-contract formulas. Higher amount of formula, no foods due to inability to eat solids-e.g., preemie (FD: 16.1) This food package can be issued prior to 6 months when advance issuing. 896 / 460 fl oz reconst conc 913 / 474 oz RTF 960 / 552 oz reconst powder. 34 / 17 cans formula 28 / 14 cans formula # cans powder ... , WIC Policy and Procedures Manual 4 . Texas WIC Health and Human Services Commission Effective: December 1, 2017 Policy No. FD: 13.0 (T) D. In-State Transfers – If a participant received an alternate contract formula with prescription and transfers to another local clinic in Texas, the gaining clinic may use the RX expiration date available in, Feb 5, 2021 ... In this VLOG two moms talk about knowing when your baby is ready to start solid foods. Also, learn how to make your own baby food at home ..., Texas WIC appreciates the decisive leadership vendors have shown to ensure food is available to infants in Texas. For questions regarding this Vendor News Flash, please contact the Vendor Management Unit’s Vendor Outreach Branch at. [email protected]. or 1-800-252-9629. Find more WIC vendor …, Formula Prescriptions. Infant Feeding Options. Partner Resources. Texas Ten Step Program. Search. You are here. ... Maya, The Texas WIC Chatbot. Close. Chat with Maya. Footer menu. How To Apply; Newsletter Sign-Up; Find a WIC office; Contact Us; Call 800-942-3678 to learn more about Texas WIC. Sub Footer., Texas WIC . Health and Human Services Commission . Effective May 1 , 202 3 Policy No. FD:1 6 .1 . FD:16.1 – Issuance of Formula Food Packages and Transfer Scenarios . WIC Policy and Procedures Manual 1 . Issuance of Formula Food Packages and Transfer Scenarios Purpose . To ensure that Texas WIC participants receive the infant formula,, WIC Policy & Procedures Manual. To download and print individual policies, choose a document on this page. The complete policy and procedures manual is also available for those who wish to download and print the entire manual at once. Complete Policy and Procedures Manual (PDF) , Texas WIC Formulary. Alfamino Infant. 593. Elemental: 20 cal/oz when mixed 1 scoop to 1 oz water; hypoallergenic amino acid based. 43% of fat is MCT oil. Similar to Elecare DHA/ARA, Neocate DHA/ARA and PurAmino. Available in PWD (14.1oz can). Condition that impairs digestion/absorption. 2) GI Disorder., All food package changes are the responsibility of a CA or WCS. For WCS, refer to Policy FD:13.0, FD:16.0, FD: 16.1 and FD:19.0 for further instructions regarding food package changes which include formula. III. Individual participant food package benefits will be aggregated on the Texas WIC card. After all family members’ food packages are ... , Families with Formula-Fed Infants. Whether you need to temporarily supplement or prefer to use formula, WIC staff can help you choose which WIC-approved formula is right for your baby. If you are breastfeeding and formula feeding, WIC staff can help you maintain your milk supply and work through any breastfeeding challenges. (starting 10/1/22), CAD Search. NDC Label Name. CAD Drug NDC. HCPCS Code*. *Miscellaneous HCPCS codes may have multiple corresponding drugs and NDCS listed. HCPCS Description. Relation start date. Enter the date in MM/DD/YYYY format, including leading 0 if needed (e.g., 03/15/2017). Relation End Date., Talk with your WIC nutritionist and use the directions below to help support your baby’s formula change. If you are also breastfeeding your baby, WIC can help you maintain your breastmilk supply while supplementing. Talk to your local WIC ofice or call the free 24/7 Texas Lactation Support Hotline at 855-550-6667., Texas homestead exemptions only need to be filed once, within two years after your homestead property taxes are due. After you file and receive your exemption, you don't need to re..., Breastfeeding and Formula Feeding. WIC is here to help you meet your breastfeeding goals. Starting or increasing formula can decrease your breastmilk supply. If you need help maintaining your supply, please talk to someone at your local WIC clinic or call the free 24/7 Texas Lactation Support Hotline at 855-550-6667., Breastfeeding and Formula Feeding. WIC is here to help you meet your breastfeeding goals. Starting or increasing formula can decrease your breastmilk supply. If you need help maintaining your supply, please talk to someone at your local WIC clinic or call the free 24/7 Texas Lactation Support Hotline at 855-550-6667., Products prescribed for inborn-errors of metabolism. (e.g., PKU) require a completed Texas WIC Medical Request for Metabolic Formula/Food (stock no, EF-16-03-13158) from a qualified metabolic Center listed on the back of the metabolic prescription form. If center is not listed, contact the SA. The metabolic form is available at., TEXAS WIC FORMULARY AND MEDICAL REASONS FOR ISSUANCE JULY 2018 . Formula Name Category Description Qualifying Conditions Staff Instructions - May issue for 1 cert period unless otherwise indicated Manufacturer . Calcilo XD Special Medical Conditions 20 cal/oz, lactose and vitamin D-free, low-calcium; nutritionally complete ..., Download a PDF form to request a medical exception for infant formula or food from the Texas WIC Program. The form requires patient information, formula name, condition, and supplemental foods., Information about formula and WIC • Monthly formula amount will change as your baby grows older. • Your baby may need more formula than your WIC package provides. • WIC may be able to give you a different formula for medical reasons. You will need a prescription from your doctor and approval from WIC. For more information call, formula. New Electronic Fillable Forms for Returned and Donated Formula . Policy FD:19.0 requires signed documentation of returned and donated formula. Updated forms are now available electronically, including: • Returned Formula Log Form: for documenting all returned formula. • WIC Formula Donation Form: for documenting formula donated to ...