Health Care Providers

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WIC Forms

Contact your local WIC office for WIC forms and other materials. Click here for a local phone number or call 1-800-342-3556 and the operator will provide you with the local phone number.

Medical Documentation for Formula and Food Form - 250 KB PDF
Medical Referral Form - 74 KB PDF
Medicaid Authorization Form - 51 KB PDF
Prenatal Weight Gain Grid for Singleton Pregnancy - 142 KB PDF
Prenatal Weight Gain Grid for Multifetal Pregnancy - 186 KB PDF

Program Information

Who is eligible for WIC and How to Apply
WIC Income Criteria - 119 KB PDF
WIC Facts - 758 KB PDF
Contract Infant Formulas - effective Summer 2011 - 526 KB PDF
Breastfeeding Facts and Research - 408 KB PDF

Outreach Materials

WIC Outreach Pamphlet
  English - 1.1 MB PDF
  Spanish - 1.1 MB PDF
  Haitian Creole - 1.1 MB PDF
Are You Pregnant? Flyer - 1.34 MB PDF
WIC Outreach Poster - 103 KB PDF

Health Care Provider Information

Health Care Providers - The New WIC Food Packages: What you should know about the changes (10/1/09)
Health Care Providers - The New WIC Food Packages: What you should know about the changes (10/1/09) ADA Compliant Version - 669 KB PDF

Some documents above are in the Portable Document Format (PDF) and you may need Adobe Acrobat Reader (opens in new window) to view or print them.