December 19, 2005 WIC Update
SUBJECT: Diet Assessment Forms To Be Used - Effective January 3, 2006
SUBJECT: Revised June 2006 Track Training Dates
SUBJECT: Consent to Release of Information and Availability of Rights and Responsibility Forms
SUBJECT: Formula Reference Sheet
- Effective January 3, 2006, Food Frequency Forms (FFQ) will be discontinued and the following forms must be used for assessing participant's diet intake status and assigning risk factors.
- Diet Intake and Nutrition Information For Children 1-6 years of Age (NHS-NPE-18, formerly WIC 45) - Yellow/Canary Paper
- Diet Intake For Females (11+ Years) (NS 16) - Green Paper
Please order these forms from the DHSS warehouse as needed. Some local WIC providers might have received the WIC 45 form: Diet Intake and Nutrition Information For Children 1-6 years of Age. This form is the same as the NHS-NPE-18 form. If you have any questions, please contact Takako Tagami at Takako.Tgami@health.mo.gov.
- New dates: June Track Training will be held June 5-6, 2006 - Due to a scheduling conflict with another training offered at this time, June Track Training has been rescheduled to June 5-6, 2006. A revised training calender is attached to this email message. If you have any questions, please contact D'Anne Ward at 1-800-392-8209 or email firstname.lastname@example.org.
- Attached is the revised Rights and Responsibilities (Rand R) in both English and Spanish to be used for those agencies who are direct entry agencies. Because of the problems with the check boxes on the R and R and obtaining initials of participant, parent, or guardian for consent to release information to other programs, the State WIC office removed the boxes. The local provider would share information in accordance with their internal policies and processes. The local provider needs to be responsible for those with whom they share information and for obtaining the appropriate permissions if they do share information. The attached forms are currently being printed at the State Printing Center and will be available at the warehouse by the end of December. For technical assistance on direct entry, please contact Glenn Studebaker at email@example.com or 1-800-392-8209. The participant or guardian still must sign the R and R form that signifies they have read or had the R and R read to them.
- During the week of December 19 - 23, 2005, the State WIC office will be resending the Missouri WIC Approved Infant Formulas, Exempt Formulas and Medical Foods Reference Sheet -Approval Authority (long name for the Formula Reference Sheet). Some LWPs requested this be sent out again.
If you have any questions and/or suggestions, please contact Takako Tagami at Takako.Tagami@health.mo.gov.