WIC Health Care Providers

Helping you access nutrition and services

Health Care Providers can play a pivotal role in ensuring families have access to nutrition and services provided by WIC. WIC provides health screening, nutrition education, nutrient rich foods, breastfeeding support and referrals to other health and social services. Below, please see the food benefits provided to WIC participants, including pregnant, breastfeeding and non-breastfeeding women, infants and children up to 5 years of age.

WIC provides women, infants and children, with a qualifying medical condition, certain special formulas and food with authorization from a physician, which is documented on the WIC Physician Authorization Form (PAF).

Resources

Formula Provided by WIC
Prescribe specialty formulas or food changes for INFANTS

When is Medical Documentation Required?

For infants, the Infant PAF must be provided before WIC can issue:

  1. Any formula other than NE WIC contract, standard infant formulas
  2. Any specialized formula, as listed on the WIC Formulary
  3. Any changes to foods provided in a standard six month infant food package

 WIC Physician Authorization Form Infants up to 12 months

Prescribe specialty formula or food changes for CHILDREN age 1-5
  • Any contract or specialty formula, as noted on the WIC formulary
  • Whole milk for children > 2 years of age. This requires prescription of a specialized formula, as well
  • 2% milk for children 1 year of age

WIC Physician Authorization Form for Children

Prescribe specialty formula or food changes for WOMEN

When is Medical Documentation Required?

For pregnant, breastfeeding or non-breastfeeding women, a PAF must be provided before WIC can issue:

  • Any specialized formula, as listed on the WIC formulary
  • Whole milk, which also requires prescription of a specialized formula

WIC Physician Authorization Form Children and Women

 

Additional resources about WIC Foods

Nebraska Food List & Shopping Guide

Common food package examples and choices