Health Care Providers All links below open in a new window 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 - 214 KB PDFMedical Referral Form - 95 KB PDFMedicaid Authorization Form - 51 KB PDFPrenatal Weight Gain Grid for Singleton Pregnancy - 151 KB PDFPrenatal Weight Gain Grid for Multifetal Pregnancy - 170 KB PDF Program Information Who is eligible for WIC and How to ApplyWIC Income Criteria - 79 KB PDFWIC Facts - 678 KB PDF Contract Infant Formulas, 2/13 - 524 KB PDFBreastfeeding Facts and Research (on page 6) - 1.36 MB PDFRefer your clients to WIC booklet - 1.36 MB PDF Outreach Materials WIC Outreach Pamphlet English - 3.13 MB PDF Spanish - 2.87 MB PDF Haitian Creole - 3.04 MB PDFAre You Pregnant? Flyer - 502 KB PDFWIC Outreach Poster - 103 KB PDF Health Care Provider Information Health Care Providers - WIC Food Packages: What you should knowHealth Care Providers - WIC Food Packages: What you should know ADA Compliant Version - 1.47 MB 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.
Health Care Providers
All links below open in a new window
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 - 214 KB PDFMedical Referral Form - 95 KB PDFMedicaid Authorization Form - 51 KB PDFPrenatal Weight Gain Grid for Singleton Pregnancy - 151 KB PDFPrenatal Weight Gain Grid for Multifetal Pregnancy - 170 KB PDF
Program Information
Who is eligible for WIC and How to ApplyWIC Income Criteria - 79 KB PDFWIC Facts - 678 KB PDF Contract Infant Formulas, 2/13 - 524 KB PDFBreastfeeding Facts and Research (on page 6) - 1.36 MB PDFRefer your clients to WIC booklet - 1.36 MB PDF
Outreach Materials
WIC Outreach Pamphlet English - 3.13 MB PDF Spanish - 2.87 MB PDF Haitian Creole - 3.04 MB PDFAre You Pregnant? Flyer - 502 KB PDFWIC Outreach Poster - 103 KB PDF
Health Care Provider Information
Health Care Providers - WIC Food Packages: What you should knowHealth Care Providers - WIC Food Packages: What you should know ADA Compliant Version - 1.47 MB PDF
