Free WIC Vendor and Participant Complaint Form, DPH 4322 - Wisconsin


File Size: 516.4 kB
Pages: 1
File Format: PDF
State: Wisconsin
Category: Health Care
Author: DHFS/DPH/BCHP/WIC
Word Count: 55 Words, 335 Characters
Page Size: Letter (8 1/2" x 11")
URL

http://dhs.wisconsin.gov/forms/DPH/DPH04322.pdf

Download WIC Vendor and Participant Complaint Form, DPH 4322 ( 516.4 kB)


Preview WIC Vendor and Participant Complaint Form, DPH 4322
DEPARTMENT OF HEALTH SERVICES Division of Public Health DPH 4322 (Rev. 02/01)

STATE OF WISCONSIN Federal Regulation 7 CFR 246.12(j) (608) 266-6912

VENDOR / PARTICIPANT COMPLAINT WISCONSIN WIC PROGRAM This form has been renumbered and revised. Please update your link with the following: http://dhs.wisconsin.gov/forms/F4/F44322.pdf