PDF
Word
Form MDHHS-5913 Authorization to Release Wic Information - Michigan
What Is Form MDHHS-5913?
This is a legal form that was released by the Michigan Department of Health and Human Services - a government authority operating within Michigan. As of today, no separate filing guidelines for the form are provided by the issuing department.
FAQ
Q: What is MDHHS-5913?A: MDHHS-5913 is the authorization form used in Michigan to release WIC information.
Q: What is WIC?A: WIC stands for Women, Infants, and Children. It is a nutrition program that provides support to low-income pregnant women, new mothers, and young children.
Q: Who can use MDHHS-5913?A: MDHHS-5913 can be used by individuals who participate in the WIC program and need to authorize the release of their information.
Q: Why would someone need to release WIC information?A: Someone might need to release WIC information to authorize the sharing of their WIC data with a specific individual or organization.
Q: Is there a cost to use MDHHS-5913?A: No, there is no cost to use MDHHS-5913. It is a free form provided by the state of Michigan.
Q: How long does the authorization on MDHHS-5913 last?A: The authorization on MDHHS-5913 lasts for a specified period of time, as indicated on the form.
Q: Can MDHHS-5913 be used to release any other type of information?A: No, MDHHS-5913 is specifically for authorizing the release of WIC information only.
Q: What happens if I don't fill out MDHHS-5913?A: If you don't fill out MDHHS-5913, your WIC information will not be shared with anyone other than those authorized by law.
Q: Can MDHHS-5913 be revoked?A: Yes, the authorization on MDHHS-5913 can be revoked at any time by submitting a written request to the appropriate WIC agency.
Form Details:
- Released on March 1, 2021;
- The latest edition provided by the Michigan Department of Health and Human Services;
- Easy to use and ready to print;
- Available in Arabic;
- Quick to customize;
- Compatible with most PDF-viewing applications;
- Fill out the form in our online filing application.
Download a printable version of Form MDHHS-5913 by clicking the link below or browse more documents and templates provided by the Michigan Department of Health and Human Services.
