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Georgia Medical Documentation Form
- https://dph.georgia.gov/document/document/georgia-medical-documentation-form-1/download
- *Note: The Georgia WIC Program only accepts prescriptions authorized and signed by the following providers: Physicians (MD, DO) Physician Assistants (PA, PA-C) Nurse …
Georgia WIC Program - Georgia Department of Public Health
- https://dph.georgia.gov/sites/dph.georgia.gov/files/WICForm%201_GA_MedicalDocForm_FillableForm_072512.pdf
- Provision of special formulas and medical foods by the Georgia WIC Program will be for intervals of one (1) to six (6) months. At a minimum, a new medical authorization is …
Georgia WIC Program - Georgia Department of Public Health
- https://dph.georgia.gov/document/document/medical-documentation-forms-1-2/download
- Documentation Form for WIC Special Formulas and WIC Foods). This form can be found at www.WIC.GA.GOV (select “Health Care Provider Information”). We appreciate your …
Georgia WIC Program - Georgia Department of Public Health
- https://dph.georgia.gov/document/document/georgia-wic-rmf-2020/download
- Georgia Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) Request for Medical Formulas and WIC Supplemental Foods Approval and provision of …
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