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Search results with tag "Special request"
Georgia WIC Program
dph.georgia.govUse this form to request special formulas and/or medical foods for patients with qualifying medical conditions. Please refer to Georgia WIC Form #2 (Referral Form & Medical Documentation for Special Food Substitutions) for children/women with food intolerances (e.g., lactose intolerance) or food allergies (e.g., milk protein allergy) that can be managed with food …
PRIVACY ACT STATEMENT THE AUTHORITY TO …
www.navygirl.orgspecial request/authorization privacy act statement the authority to request this information is contained in 5 usc 301, and frim e.o. 9397 departmental regulations.