Time Money, Money, Money Forms and Documents People Miscellaneous
100
What is 20 minutes?
This is the grace period for late arrivals to appointments
100
What is adjunctively eligible?
Clients who participant in Medicaid, SNAP or TANF are considered this
100
What is the WIC Program Booklet?
This item provided to clients answers frequent questions, lists upcoming appointments and provides guidance on WIC allowable foods
100
Who is the authorized representative?
They are responsible for the eWIC card
100
What is a short certification?
This certification allows for 30 days of benefits even if client cannot present proof of identification, residency or income
200
What is 10 days?
This is time frame in which high risk or special nutrition risk appointments should be seen
200
What is a household of one?
For income purposes, all foster children should be considered this.
200
What is the Shopping List
This form generated by INWIC informs the participant of benefits loaded to the card
200
Who is the proxy?
The eWIC card does not serve as identification for this person
200
What is powdered?
This is the preferred form for standard infant formula and requires no prescription regardless of gestational age
300
What is 2 years?
This is the minimum age a child be weighed on the adult scales
300
What is 185% of poverty line?
The Federal income guidelines for WIC participants are determined by this
300
What is No Proof Letter
This form, required to e-sign only, is used when client cannot provide income, identification or residency due to homelessness, theft or migrant farm work
300
Who is the Coordinator or WIC representative?
This person must sign printed Termination Notices
300
What is a Competent Professional Authority
CPA is a WIC approved acronym that stands for this
400
What is 30 days of benefits?
If a client is deemed over income with over 90 days left in the certification, this is how many days of benefits they may receive
400
What is victim of theft, victim of fire, homeless or migrant farm worker?
A no proof form must be completed as exemption of proof of income due to this
400
What is consent for services and rights to services and responsibilities?
Clients or person present with infant or child client with a change of custody must read these
400
Who is the staff member releasing information?
This person signs under the participant on the Release of Information form
400
What is anemia? (hgb equal or less than 10gm/dl)
This risk factor is listed by the number 201
500
What is all of the remaining days?
If a client is deemed over income with fewer than 90 days left in certification, this is how many days of benefits they may receive
500
What is a household of one? (this includes when parents are incarcerated)
For income purposes, children who are residing with relatives (not parents) and/or friends for one year or less are considered this.
500
What are Eligibility of Public Benefits, Sanctions Due to Program Violations and Voter Registration
Once completed, clinics are required to maintain a paper file of these forms
500
What is the Medicaid Interchange
This online service shows proof of health coverage and can be counted as proof of identification, residency and income, without a card
500
What is 22-110 pounts?
The child Masimo may be used on WIC clients in this weight range






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