Things You Need To Apply For WIC

Your local WIC clinic staff will ask you for proof of identity, pregnancy (if needed), income, address, household size, immunization (for your infant or child under the age of five) and nutritional risk. To help determine nutritional risk and/or proof of pregnancy, you may be asked to fill out parts of the WIC Program Medical Referral Form. You will have to ask your doctor or health clinic staff to complete the remaining parts and return the form to the WIC clinic.

This is a checklist of documents and other items that you can use when you apply for WIC benefits. If you do not have or cannot get some of these items, WIC staff will tell you about others that can be used. You must bring at least one document from each section.

• Proof of Residence - To prove where you live and who lives with you, you can use:
  • New York State Driver's License or Non-Driver Identification Card
  • Identification card with address
  • Lease letter or rent receipt from landlord
  • Bill (electric, heat, phone, credit card)
  • Letter or statement from a federal, state or local government agency (Social Security, Department of Social Services, military, etc.)
  • Paycheck or stub with home address
  • Bank statement
   
• Proof of Category - To prove that you are pregnant or that your infant or child is under the age of five, you can use:
  • Completed WIC Program Medical Referral Form
  • Birth Certificate (for infant or child)
  • Confirmation of pregnancy
   
• Proof of Income - To prove the amount of income you and your family earn, you can use:
  • Most recent pay stub
  • AFDC (Public Assistance) card
  • Food Stamps Card
  • Unemployment card
  • VOC Card
  • W-2 (Income Tax Statement of Wages and Earnings) form
  • Medicaid card or letter
  • Other documents (ask your WIC clinic staff)

Note: If you are a migrant worker or homeless, and cannot provide proof of the above, you can still apply for WIC.
 

• Proof of Nutritional Risk - To prove that you or your infant or child is at nutritional risk, you may be asked to have the WIC Medical Referral Form completed by your doctor or health clinic. Or, the WIC clinic staff may do the blood tests, and weigh and measure you, your infant or child at the WIC clinic.
  
• Proof of Immunization - To prove that your infant or child under age 5 has received all recommended immunizations, you can use:
  • Immunization record card
  • Completed WIC Medical Referral Form, with immunization information attached.

Standards for participation in the WIC Program are the same for everyone
If you believe you have been discriminated against because of race, color, national origin, age, sex, or handicap, write immediately to:

Secretary of Agriculture
Washington, D.C. 20250

If you feel you have been discriminated against
based on religion or political belief, call, toll-free,
1-800-522-5006.