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WIC (Women, Infants, and Children) Program

Message to Healthcare Providers

As a health care and social services provider, improving maternal and child health is a goal that you share with the WIC program. Below you’ll find WIC medical request forms, breastfeeding promotion materials, and other resources.

WIC can provide non-contract formula and modified food packages when needed.* Before requesting a non-contract formula, check the list of WIC contract formulas to see if one of the formulas is appropriate for your patient. If there is not a suitable choice or if you need to request any type of formula for a patient over 12 months of age (contract or non-contract), you’ll need to complete a request form. Click on the link below for instructions:

How to Request Formula and Foods, Soy Foods, Tofu, or Gluten-Free Cereal

Medical RequestForm for Formula.Food 

Medical Request Form for Metabolic Formula/Food

Texas WIC Formulary
 

Formula Maximum Quantity Table
 

Formula - Frequently Asked Questions


Other WIC Program Resources

Breastfeeding Promotion and Support
– Learn about WIC’s focus on exclusive breastfeeding and efforts to get more moms to breastfeed. Also find out about breastfeeding trainings for Health-Care Providers.

Texas WIC Catalog
– Go here for pamphlets, posters and other materials to use in your practice. (Note: Most materials can be ordered via e-mail in limited supply and many are printable to non-WIC providers. Videos are available for the cost of duplication, shipping and handling. See ordering information  for details.)

*Please note: all requests for non-contract formula are subject to approval by the Texas WIC program. This approval process is designed to help providers offer the best care for WIC participants. WIC is able to approve most requests for formulas that are listed in the Texas WIC Formulary that have the proper medical documentation based on reasons for issuance as noted in the Texas WIC formulary.

Last updated: May 17, 2013