State of Alaska | WIC Enteral Prescription Nutrition Request

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ENPR - Enteral Prescription Nutrition Request

Formerly Non-Contract Formula

Forms:

Click here for FORMS. Use these forms in requesting WIC state office approval of a non-contract formula prescription.

Policies and Information:

Use these policies and forms in requesting WIC state office approval of a non-contract formula prescription. For more information, select a link from below:

ENPR Toolkit

ENPR Form (pdf)
ENPR Non Contract Formula List (pdf)
ENPR Non Contract Policy (pdf)
Summary of Changes to Medical Documentation (pdf)
Medical Documentation for Infants and Children (pdf)
Medical Documentation for Women (pdf)
Monthly Allowances for Children and Women in Food Packages IV-VII (pdf)

To address technical problems or make suggestions regarding this site, please email:
wic@alaska.gov

Other contact information:
Family Nutrition Services State of Alaska/DHSS/DPA
Address:	130 Seward St PO Box 110612 Juneau, AK 99801	Main office: Fax:	(907) 465-3100 (907) 465-3416

Family Nutrition