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