Handouts/Forms
The handout that is green and has a little girl holding an artichoke is called...
Raising a Healthy Eater
What other names do we call this handout?
No longer taking prenatal vitamins
Inappropriate Nutrition Practices for Women (427)
Which is the following is not a responsibility of a WCS?
a) counsel on low iron using handout
b) call doctor's office regarding diagnosis on Rx
c) schedule appointments in Teletask
B
The number of attempts needed to be made for telephone appointments
3
Sweet potatoes, oranges, bell peppers, and broccoli are all rich in this nutrient.
Vitamin C
This form is used if the applicant/participant does not have documentation of wages. It can also be used when an individual begins a new job and has not received his/her first paycheck.
19-b
Participant is 15 weeks along and is breastfeeding her 18 month old daughter
Pregnant Woman Currently Breastfeeding (338)
We use 1040 (tax return) to determine income in this case.
Overtime is frequent and consistent AND reflective of current income.
As a general rule, a caller should not be placed on hold longer than how many minutes?
1 minute
This fun character loves fruits and vegetables and has lots of adventures through reading and dancing.
Zobey
You should use this form when a participant (or household member), who is self-employed, does not have the most recent tax return. You can also use this form if the participant (or household member) is paid in cash and the employer will not complete documentation (19-b), OR if the paycheck stub(s) are not in his/her name.
32
"Applicant's Statement of Farm/Self-Employed"
<32 oz of formula per day without vitamin D
Inappropriate Nutrition Practices for Infants (411)
These things needed for a paystub.
Pay Date
Employer Information
Recipient's Name
Gross Pay
Daily Double
Role Play.
You're counseling a family with a child who is considered obese.
This town will be the new location for the Leon County WIC office.
Buffalo
This form can be used in the following cases:
- no proof of ID due to theft/loss/disaster/homelessness/migrant worker
- no proof of address due to theft/loss/disaster/homelessness/migrant worker
- no income and the form 19-a is not applicable
- cash on hand
Self-Declaration Form
Child has autism
Developmental, Sensory or Motor Disabilities Interfering with the Ability to Eat (362)
These are 5 ways to be adjunct eligible.
1) SNAP
2) TANF
3) Medicaid
4) someone in house TANF
5) pregnant and/or infant Medicaid
These 3 things MUST be verified when making an appointment over the phone.
Name
DOB
Phone number
This country requires mothers to breastfeed for 2 years.
UAE
Who can complete section 2 of the WIC 19-a form?
19-a is used if the applicant/participant indicates that no one in the household has any income.
Section 1 is to be completed by someone outside of the household who is providing support.
Section 2 should be completed by a 3rd party when there is no household income AND the household does not receive outside assistance. 3rd parties cannot include a household member, WIC staff, or relative.
Postpartum mom had 201 code assigned at pregnancy appointment and has a hemoglobin reading of 12.8 at recertification. She has no other risk conditions.
Possibility of Regression (501)
Daily Double
Role Play.
A participant is demanding more formula because WIC doesn't provide enough.
These pieces of information should be included in the Teletask notes when scheduling the appointment.
Your initials
Style of appointment (SC, IP, Mom/Baby/etc)
Additional information like call at xyz, HOT CARD, etc.
A hard surface must remain wet with a disinfecting spray or wipe for ____ in order for it to be considered disinfected.
3-4 minutes (always read the manufacturer's instructions for proper usage)