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Form ODH3989.23 Ohio Wic Prescribed Formula and Food Request Form - Ohio
What Is Form ODH3989.23?
This is a legal form that was released by the Ohio Department of Health - a government authority operating within Ohio. As of today, no separate filing guidelines for the form are provided by the issuing department.
FAQ
Q: What is Form ODH3989.23?
A: Form ODH3989.23 is the Ohio WIC Prescribed Formula and Food Request Form.
Q: What is the purpose of Form ODH3989.23?
A: The purpose of Form ODH3989.23 is to request prescribed formula and food from the Ohio WIC program.
Q: Who can use Form ODH3989.23?
A: Form ODH3989.23 can be used by participants of the Ohio WIC program who need to request prescribed formula and food.
Q: Is there a cost to submit Form ODH3989.23?
A: No, there is no cost to submit Form ODH3989.23.
Form Details:
- Released on June 1, 2022;
- The latest edition provided by the Ohio Department of Health;
- Easy to use and ready to print;
- Quick to customize;
- Compatible with most PDF-viewing applications;
- Fill out the form in our online filing application.
Download a fillable version of Form ODH3989.23 by clicking the link below or browse more documents and templates provided by the Ohio Department of Health.
Download Form ODH3989.23 Ohio Wic Prescribed Formula and Food Request Form - Ohio
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