It’s easy to apply for WIC. Simply call our clinic at 419-334-6363 to schedule an appointment and

bring the following required documentation from the checklist below:

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WIC Appointment Checklist Reminder

 

WIC Appointment Policy

 

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Print and complete the forms below that apply to you or your child,

and bring them with you to your scheduled appointment.

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Available WIC Forms:

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WIC Program Application Form

 

WIC Health History for Infants

-Historial de Salud de WIC para Infantes

 

WIC Health History for Children

-Historial de Salud para Niños de 1 hasta 5 Años

 

WIC Health History for Pregnant Women

-Historial de Salud de WIC para Mujeres Embarazadas

 

WIC Health History for Breastfeeding and Postpartum Women

-Historial de Salud de WIC para Mujures Lactando/Amamantando o en Postparto