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Pennsylvania WIC PROGRAM Prescription for Special Formula Clients First & Last Name Birth Date Parent/Caregiver( 's) First & Last Name PLEASE NOTE Health care providers must answer/complete.

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The times of frightening complicated tax and legal documents are over. With US Legal Forms the process of completing legal documents is anxiety-free. The best editor is already close at hand offering you multiple beneficial tools for completing a Pennsylvania WIC PROGRAM Prescription For Special Formula. These tips, with the editor will help you with the entire process.

  1. Select the orange Get Form button to start filling out.
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  4. Be sure the info you add to the Pennsylvania WIC PROGRAM Prescription For Special Formula is up-to-date and correct.
  5. Include the date to the form using the Date function.
  6. Click the Sign icon and create a signature. You will find 3 options; typing, drawing, or capturing one.
  7. Make sure that each field has been filled in properly.
  8. Select Done in the top right corne to export the record. There are many alternatives for getting the doc. An attachment in an email or through the mail as a hard copy, as an instant download.

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