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West Virginia WIC Policy & Procedure 3.16 Effective Date: 7/5/2017 3.16 Special Formula Distribution System

If formula is changed by the physician (providing the participant supplies a Prescription Formula Documentation Form, WIC-53) between cycles. The participant must return any unused formula prior to replacement issuance.

If formula is damaged or out-of-date; or

Non-receipt of initial order. In this case the replacement order and all future orders must be sent to the clinic site. 2. Instruct the participant that should formula need to be replaced for any of the above reasons, they must notify the Local Agency and return unused formula to the local clinic before new formula can be ordered. This must be tracked on the Formula Tracking form and non-damaged and out-of-date formula must be entered into Crossroads inventory. 3. The clinic site must contact the WIC Help Desk for replacement. G. Usage of Returned Special Formula 1. Special formula that is returned by a participant or is not needed once received from the Distribution Center can be issued to another participant. The returned formula is to be entered into the inventory within Crossroads. 2. To issue the returned formula to another client, the clinic staff will issue the formula from inventory within Crossroads on the food issuance screen. If there is not enough to fill the entire month, the remainder can be ordered thru the warehouse through the formula wizard. 3. If the product will go out of date within ninety (90) days, or if usage of the formula at the Local Agency is considered unlikely, notify the Help Desk and they can assist in finding another area that the formula may be used. a. The Local Agency, with the formula (sending Agency), will arrange with the appropriate Local Agency, needing the formula (receiving Agency) to ship the formula to that Local Agency, clinic site, or participant. b. The sending Local Agency will contact the shipper and incur shipping costs. The State Agency may be invoiced for shipping cost incurred. c. The receiving site will issue a request to transfer the formula from the original site through Crossroads. If they are in a different Local Agency, contact the WIC Help Desk staff for assistance. 3 of 5