Clinician (Printable) & Other Forms

• Request for Special Food and Formula

• Medical Referral Form for Post Partum Women

• Medical Referral Form for Children

• WIC Formula feeding brochure #278  

USDA Discrimination Complaint

This form may be used if you believe you have been subjected to discrimination in any USDA program or activity and you wish to file a complaint.

• English  – Online Complaint Form

• Spanish – Online Complaint Form
  

WIC General Brochures

• ENGLISH

• SPANISH

• PORTUGUESE

• CHINESE

• FRENCH

• RUSSIAN

• ARABIC

• KHMER

• VIETNAMESE

WIC Food Guide – JULY 2022 – SEVEN LANGUAGES

• English

• Spanish

• Portuguese

• Chinese

• Vietnamese

• French

• Arabic

Authorization  Release

• Authorization For Release Of Information From WIC – English

• Authorization For Release Of Information From WIC – Spanish 

WIC Rights and Responsibilities

• WIC Rights and Responsibilities – English

• WIC Rights and Responsibilities – Spanish

• WIC Rights and Responsibilities – Portuguese

WIC Eligibility Agreement

• WIC Eligibility Agreement – English

• WIC Eligibiltiy Agreement – Spanish

• WIC Eligibiltiy Agreement – Portuguese